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The influence of additional surgical margins on the total specimen volume excised and the reoperative rate after breast-conserving surgery.
Am J Surg. 2006 Oct; 192(4):509-12.AJ

Abstract

BACKGROUND

It is unclear whether the additional removal of breast tissue during breast-conserving therapy (BCT) for breast cancer beyond the standard lumpectomy reduces the incidence of inadequate microscopic margins found at pathological examination and subsequent reoperation. This study compares the reoperative rates after initial BCT in 3 groups of patients who underwent lumpectomy with complete resection of 4 to 6 additional margins, lumpectomy with selective resection of 1 to 3 additional margins, or standard lumpectomy.

METHODS

Retrospective data were reviewed from 171 selected cases of BCT, from May 2000 to February 2006. Forty-five cases involved lumpectomy with complete resection of 4 to 6 additional margins; 77 involved lumpectomy with selective resection of 1 to 3 additional margins, whereas 49 involved standard lumpectomy. All samples underwent pathologic analysis of inked resection margins by permanent section. The 3 groups were compared for patient demographics, tumor size and histologic subtype, tumor stage, margin status, excised specimen volume, and eventual subsequent reoperation. Adequate surgical margin was defined as any negative margin greater than 2 mm.

RESULTS

The group with complete resection of 4 to 6 additional margins had a subsequent reoperation rate of 17.7%, whereas the group with selective resection of 1 to 3 additional margins and the standard lumpectomy group had a subsequent reoperation rate of 32.5% and 38.7%, respectively, because of inadequate margins. The mean total excised specimen volume in the 3 groups was 129.19, 46.04, and 37.44 cm3, respectively.

CONCLUSIONS

The complete resection of 4 to 6 additional margins during the initial BCT resulted in the lowest subsequent reoperation rate, and the largest total volume specimen excised among the 3 techniques studied.

Authors+Show Affiliations

New York Presbyterian Hospital, Cornell University, 425 East 61st Street, 8th Floor, New York, NY 10021, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16978962

Citation

Huston, Tara L., et al. "The Influence of Additional Surgical Margins On the Total Specimen Volume Excised and the Reoperative Rate After Breast-conserving Surgery." American Journal of Surgery, vol. 192, no. 4, 2006, pp. 509-12.
Huston TL, Pigalarga R, Osborne MP, et al. The influence of additional surgical margins on the total specimen volume excised and the reoperative rate after breast-conserving surgery. Am J Surg. 2006;192(4):509-12.
Huston, T. L., Pigalarga, R., Osborne, M. P., & Tousimis, E. (2006). The influence of additional surgical margins on the total specimen volume excised and the reoperative rate after breast-conserving surgery. American Journal of Surgery, 192(4), 509-12.
Huston TL, et al. The Influence of Additional Surgical Margins On the Total Specimen Volume Excised and the Reoperative Rate After Breast-conserving Surgery. Am J Surg. 2006;192(4):509-12. PubMed PMID: 16978962.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The influence of additional surgical margins on the total specimen volume excised and the reoperative rate after breast-conserving surgery. AU - Huston,Tara L, AU - Pigalarga,Rodolfo, AU - Osborne,Michael P, AU - Tousimis,Eleni, PY - 2006/04/06/received PY - 2006/06/04/revised PY - 2006/06/04/accepted PY - 2006/9/19/pubmed PY - 2006/11/7/medline PY - 2006/9/19/entrez SP - 509 EP - 12 JF - American journal of surgery JO - Am J Surg VL - 192 IS - 4 N2 - BACKGROUND: It is unclear whether the additional removal of breast tissue during breast-conserving therapy (BCT) for breast cancer beyond the standard lumpectomy reduces the incidence of inadequate microscopic margins found at pathological examination and subsequent reoperation. This study compares the reoperative rates after initial BCT in 3 groups of patients who underwent lumpectomy with complete resection of 4 to 6 additional margins, lumpectomy with selective resection of 1 to 3 additional margins, or standard lumpectomy. METHODS: Retrospective data were reviewed from 171 selected cases of BCT, from May 2000 to February 2006. Forty-five cases involved lumpectomy with complete resection of 4 to 6 additional margins; 77 involved lumpectomy with selective resection of 1 to 3 additional margins, whereas 49 involved standard lumpectomy. All samples underwent pathologic analysis of inked resection margins by permanent section. The 3 groups were compared for patient demographics, tumor size and histologic subtype, tumor stage, margin status, excised specimen volume, and eventual subsequent reoperation. Adequate surgical margin was defined as any negative margin greater than 2 mm. RESULTS: The group with complete resection of 4 to 6 additional margins had a subsequent reoperation rate of 17.7%, whereas the group with selective resection of 1 to 3 additional margins and the standard lumpectomy group had a subsequent reoperation rate of 32.5% and 38.7%, respectively, because of inadequate margins. The mean total excised specimen volume in the 3 groups was 129.19, 46.04, and 37.44 cm3, respectively. CONCLUSIONS: The complete resection of 4 to 6 additional margins during the initial BCT resulted in the lowest subsequent reoperation rate, and the largest total volume specimen excised among the 3 techniques studied. SN - 0002-9610 UR - https://www.unboundmedicine.com/medline/citation/16978962/The_influence_of_additional_surgical_margins_on_the_total_specimen_volume_excised_and_the_reoperative_rate_after_breast_conserving_surgery_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9610(06)00430-2 DB - PRIME DP - Unbound Medicine ER -