Mastectomy Research Today is a free monthly online journal that collates and summarizes the latest research about Mastectomy, including details on breast cancer, prosthesis, recovery, surgery, complications.

Multiple re-excisions versus mastectomy in patients with persistent residual disease following breast conservation surgery.

Cellini C, Huston TL, Martins D, Christos P, Carson J, Kemper S, Simmons RM

Weill Medical College of Cornell University, Department of Surgery, New York, NY, USA.

BACKGROUND: Persistently involved margins following breast conservation surgery (BCS) create a diagnostic dilemma regarding the recommendation of further BCS or mastectomy. METHODS: A retrospective review of 276 breast cancer patients who underwent BCS and required additional surgical treatment between 1990-2002 was performed. RESULTS: For treatment of persistently involved margins, 63% of subjects underwent re-excision the first time, 49% the second time, and 37% the third time. The incidence of residual carcinoma increased linearly with the number of initially involved margins (P = .03). Ductal carcinoma-in-situ (DCIS) or infiltrating lobular carcinoma (IFLC) primary histology was associated with a higher rate of residual cancer compared to invasive ductal carcinoma (IFDC) (62% vs. 69% vs. 54%, respectively, P = .56). A trend towards an increased risk of residual cancer in primary tumors > or =2 cm versus tumors under 2 cm was also evident (63%% vs. 50%, respectively, P = .38). CONCLUSIONS: Approximately half of patients repeatedly selected BCS over mastectomy. It is important to realistically discuss the probability of definitive resection with patients who are undergoing breast conservation with re-excision.

Published 24 May 2005 in Am J Surg, 189(6): 662-6.
Full-text of this article is available online (may require subscription).

© 2004-2008 Mastectomy Research Today. All Rights Reserved.