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.

The relationship between surgical factors and margin status after breast-conservation surgery for early stage breast cancer.

Lovrics PJ, Cornacchi SD, Farrokhyar F, Garnett A, Chen V, Franic S, Simunovic M

Department of Surgery, McMaster University, Hamilton Health Sciences, St. Joseph's Healthcare, Hamilton, Ontario, Canada. lovricsp@mcmaster.ca

BACKGROUND: The study's aim was to identify technical factors that are predictive of negative margins after breast-conserving surgery (BCS). METHODS: This was a retrospective, cohort study of patients who underwent BCS for early-stage cancer from 2000 to 2002. Pathological and specific surgical factors were compared with margin status. Univariate and multivariate regression analyses were performed. RESULTS: Four hundred eighty-nine cases were reviewed. The positive margin rate after the initial surgery was 26%. In univariate analysis, lobular histology, size, grade, multifocality, and the presence of EIC and LVI were associated with positive margins (P < .05). The absence of cavity margin dissection and specimen orientation labeling, the absence of a confirmed diagnosis, and smaller volumes of excision were also associated with positive margins (P < .05). In multivariate analysis, confirmed diagnosis, small tumor size, ductal histology, absence of LVI and multifocality, palpability, cavity margin dissection, and larger volumes of excision were predictors of negative margins. CONCLUSIONS: This study shows that specific surgical factors are predictive of margin status. Both tumor and technical factors should be considered when planning BCS.

Published 5 June 2009 in Am J Surg, 197(6): 740-6.
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