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Does intraductal breast cancer spread in a segmental distribution? An analysis of residual tumour burden following segmental mastectomy using tumour bed biopsies.
Eur J Surg Oncol. 2001 Feb; 27(1):21-5.EJ

Abstract

INTRODUCTION

Breast-conserving surgery for early breast cancer is now routinely used as an alternative to mastectomy. Despite post-operative radiotherapy, early local recurrence of tumour remains a concern. It has been reported that invasive and in-situ ductal carcinoma spread locally through the ductal tree in a segmental distribution, however, there is no consensus as to the best surgical method to maximize tumour clearance whilst leaving a good cosmetic result.

AIM

We aimed to measure the effectiveness of segmental mastectomy (excision of tumour plus associated segmental ductal tissue) in the clearance of different tumour types. Bed biopsy of the excision cavity was employed to assess the rate of incomplete excision or the multifocality of certain breast cancers.

METHODS

One hundred and one patients with breast cancers underwent segmental mastectomy and cavity bed biopsies. Specimens were assessed for tumour type and completeness of excision. An excision of the cancer was considered incomplete if the margins were involved or if any of the bed biopsies showed residual or multifocal tumour.

RESULTS

A total of 24 patients had incomplete tumour excision. Invasive ductal carcinoma was more likely to be completely excised by segmental mastectomy than invasive lobular carcinoma (P<0.05). Incomplete excision was associated with multifocality and the presence of extensive DCIS. The report of clear pathological margins was significantly more likely to be accurate, as measured by negative bed biopsies, in invasive ductal carcinoma when compared to invasive lobular carcinoma (P<0.05).

CONCLUSION

These results support the concept that ductal carcinomas spread locally in a segmental fashion. Patients with invasive ductal carcinomas are more likely to benefit from breast conserving surgery that is tailored to include the associated ductal tissue, in a segmental fashioned excision.

Authors+Show Affiliations

The Breast Surgery Unit, St Bartholomew's Hospital, The Royal Hospitals NHS Trust, West Smithfield, London EC1A 7BE, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11237487

Citation

Jenkinson, A D., et al. "Does Intraductal Breast Cancer Spread in a Segmental Distribution? an Analysis of Residual Tumour Burden Following Segmental Mastectomy Using Tumour Bed Biopsies." European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, vol. 27, no. 1, 2001, pp. 21-5.
Jenkinson AD, Al-Mufti RA, Mohsen Y, et al. Does intraductal breast cancer spread in a segmental distribution? An analysis of residual tumour burden following segmental mastectomy using tumour bed biopsies. Eur J Surg Oncol. 2001;27(1):21-5.
Jenkinson, A. D., Al-Mufti, R. A., Mohsen, Y., Berry, M. J., Wells, C., & Carpenter, R. (2001). Does intraductal breast cancer spread in a segmental distribution? An analysis of residual tumour burden following segmental mastectomy using tumour bed biopsies. European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 27(1), 21-5.
Jenkinson AD, et al. Does Intraductal Breast Cancer Spread in a Segmental Distribution? an Analysis of Residual Tumour Burden Following Segmental Mastectomy Using Tumour Bed Biopsies. Eur J Surg Oncol. 2001;27(1):21-5. PubMed PMID: 11237487.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Does intraductal breast cancer spread in a segmental distribution? An analysis of residual tumour burden following segmental mastectomy using tumour bed biopsies. AU - Jenkinson,A D, AU - Al-Mufti,R A, AU - Mohsen,Y, AU - Berry,M J, AU - Wells,C, AU - Carpenter,R, PY - 2001/3/10/pubmed PY - 2001/4/3/medline PY - 2001/3/10/entrez SP - 21 EP - 5 JF - European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology JO - Eur J Surg Oncol VL - 27 IS - 1 N2 - INTRODUCTION: Breast-conserving surgery for early breast cancer is now routinely used as an alternative to mastectomy. Despite post-operative radiotherapy, early local recurrence of tumour remains a concern. It has been reported that invasive and in-situ ductal carcinoma spread locally through the ductal tree in a segmental distribution, however, there is no consensus as to the best surgical method to maximize tumour clearance whilst leaving a good cosmetic result. AIM: We aimed to measure the effectiveness of segmental mastectomy (excision of tumour plus associated segmental ductal tissue) in the clearance of different tumour types. Bed biopsy of the excision cavity was employed to assess the rate of incomplete excision or the multifocality of certain breast cancers. METHODS: One hundred and one patients with breast cancers underwent segmental mastectomy and cavity bed biopsies. Specimens were assessed for tumour type and completeness of excision. An excision of the cancer was considered incomplete if the margins were involved or if any of the bed biopsies showed residual or multifocal tumour. RESULTS: A total of 24 patients had incomplete tumour excision. Invasive ductal carcinoma was more likely to be completely excised by segmental mastectomy than invasive lobular carcinoma (P<0.05). Incomplete excision was associated with multifocality and the presence of extensive DCIS. The report of clear pathological margins was significantly more likely to be accurate, as measured by negative bed biopsies, in invasive ductal carcinoma when compared to invasive lobular carcinoma (P<0.05). CONCLUSION: These results support the concept that ductal carcinomas spread locally in a segmental fashion. Patients with invasive ductal carcinomas are more likely to benefit from breast conserving surgery that is tailored to include the associated ductal tissue, in a segmental fashioned excision. SN - 0748-7983 UR - https://www.unboundmedicine.com/medline/citation/11237487/Does_intraductal_breast_cancer_spread_in_a_segmental_distribution_An_analysis_of_residual_tumour_burden_following_segmental_mastectomy_using_tumour_bed_biopsies_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0748-7983(00)91051-5 DB - PRIME DP - Unbound Medicine ER -