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The impact of re-excision and residual disease on local recurrence after breast conservation treatment for patients with early stage breast cancer.

Abstract：

UNLABELLED:The current study examined the impact of re-excision and residual disease on local recurrence after breast conservation treatment for patients with negative margins. Patients with residual disease on re-excision had a higher local recurrence rate than other patients. However, with reasonably low local recurrence rates in all subgroups, neither re-excision nor residual disease on re-excision are contraindications for breast conservation treatment. PURPOSE:To evaluate the impact of re-excision and the presence of residual disease on local recurrence for patients who underwent breast conservation treatment (BCT) with negative final resection margins. METHODS:The records of 902 patients with stage I or II unilateral invasive breast cancer who had BCT were reviewed. The study cohort consisted of patients with negative final resection margins and was divided into 3 subgroups: (a) single excision (n = 332 [37%]), (b) re-excision with no residual disease in the re-excision specimen (n = 440 [49%]), and (c) re-excision with residual disease in the re-excision specimen (n = 130 [14%]). The median follow-up was 6.75 years. RESULTS:At 15 years, the rates of local failure were 10% for patients with a single excision, 10% for patients with a re-excision without residual disease, and 16% for patients with a re-excision with residual disease (P = .033). There were no significant differences between the 3 groups for overall survival, cause-specific survival, relapse-free survival, or freedom from distant metastases (all P ≥ .082). Multivariate analysis demonstrated an increased risk of local failure for patients with residual disease in the re-excision specimen that was borderline statistically significant (hazard ratio, 2.16; P = .061). CONCLUSIONS:Despite achieving negative final resection margins, the patients with residual disease in the re-excision specimen had a higher rate of local recurrence than patients who underwent single excision or patients without residual disease on re-excision. However, local recurrence was reasonably low in all 3 subgroups, and, therefore, neither re-excision nor residual disease represent contraindications for BCT.

journal_name

Clin Breast Cancer

journal_title

Clinical breast cancer

authors

Ali AN,Vapiwala N,Guo M,Hwang WT,Harris EE,Solin LJ

doi

10.1016/j.clbc.2011.08.003

subject

Has Abstract

pub_date

2011-12-01 00:00:00

pages

400-5

issue

eissn

1526-8209

issn

1938-0666

pii

S1526-8209(11)00160-1

journal_volume

pub_type

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The impact of re-excision and residual disease on local recurrence after breast conservation treatment for patients with early stage breast cancer.