Re-excision of margins before breast radiation-diagnostic or therapeutic?

Journal Article · Tue Aug 01 04:00:00 UTC 2006 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2006.02.017· OSTI ID:20850023

Chism, Derek B ^[1]; Freedman, Gary M ^[2]; Li, Tianyu ^[3]; Anderson, Penny R ^[2]

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1. Department of Radiation Oncology, North Shore Medical Center, Peabody, MA (United States)
2. Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States)
3. Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, PA (United States)

Purpose: To identify factors in breast cancer patients that predict the pathologic results of re-excision for close or positive margins and to determine the effect on local control. Methods and Materials: We divided 1,044 patients with Stage I-II breast cancer with a close ({<=}2 mm) or positive margin after initial excision into three groups. Group 1 included 199 patients without additional excision, Group 2 included 546 patients with re-excision found to be free of cancer, and Group 3 included 299 patients with re-excision and residual cancer. All patients were treated with radiotherapy with a median follow-up of 6.7 years. Results: The 10-year local control rate was 95% for Group 1 and 94% for Groups 2 and 3 (p = 0.788). Of the 846 patients, 65% had no residual disease on re-excision and 35% did have residual tumor. The factors significantly associated with positive re-excision findings were initial positive margins, positive nodes, Stage T2 tumor, and an extensive intraductal component. The 10-year local control rate was 95% for Group 2 vs. 91% for Group 3 (p = 0.038). Conclusion: The low recurrence rates seen in this study suggest that selected patients with non-negative margins, particularly those with a low risk of having residual disease at re-excision, may be treated with radiotherapy.

• OSTI ID: 20850023
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 5 Vol. 65; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
HEALTH HAZARDS
MAMMARY GLANDS
PATIENTS
RADIOTHERAPY
SURGERY