The American Journal of Surgery
Volume 198, Issue 6 , Pages 771-780 , December 2009

Impact of initial surgical margins and residual cancer upon re-excision on outcome of patients with localized breast cancer

  • Natalia B. Kouzminova, M.D.

      Affiliations

    • Department of Hematology/Oncology, Santa Clara Valley Medical Center, Santa Clara, CA, USA
    • Corresponding Author InformationCorresponding author. Tel.: 408-793-1980; fax: 408-793-2063
    • ,
  • Sangeeta Aggarwal, M.D.

      Affiliations

    • Department of Hematology/Oncology, Santa Clara Valley Medical Center, Santa Clara, CA, USA
    • ,
  • Adeeti Aggarwal

      Affiliations

    • Saratoga High School, Saratoga, CA, USA
    • ,
  • Maria D. Allo, M.D.

      Affiliations

    • Department of Surgery, Santa Clara Valley Medical Center, Santa Clara, CA, USA
    • ,
  • Albert Y. Lin, M.D.

      Affiliations

    • Department of Hematology/Oncology, Santa Clara Valley Medical Center, Santa Clara, CA, USA

Received 5 March 2009 ,Revised 19 May 2009

References 

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  2. Veronesi U, Cascinelli , Mariani L, et al. Twenty-year follow up of a randomized study comparing breast conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347:1227–1232
  3. Cady B, Punglia RS, Morrow M, Harris JR. Local therapy and survival in breast cancer. N Engl J Med. 2007;357:2399–2405
  4. Arrigada R, Le MG, Rochard F, Contesso G Institut Gustave-Roussy Breast Cancer Group. Conservative treatment versus mastectomy in early breast cancer: patterns of failure with 15 years of follow-up data. J Clin Oncol. 1996;14:1558–1564
  5. Clarke M, Collins R, Darby S, et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005;366:2087–2106
  6. Mirza NQ, Vlastos G, Meric F, et al. Predictors of locoregional recurrence among patients with early-stage breast cancer treated with breast-conserving therapy. Ann Surg Oncol. 2002;9:256–265
  7. Van Dongen JA, Voogd AC, Fentiman IS, et al. Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy: European Organization for Research and Treatment of Cancer 10801 trial. J Natl Cancer Inst. 2000;92:1143–1150
  8. Jatoi I, Proschan MA. Randomized trials of breast-conserving therapy versus mastectomy for primary breast cancer: a pooled analysis of updated results. Am J Clin Oncol. 2005;28:289–294
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  11. Smitt MC, Nowels KW, Zdeblick MJ, et al. The importance of the lumpectomy surgical margin status in long-term results of breast conservation. Cancer. 1995;76:259–267
  12. Vicini FA, Kestin L, Huang R, Martinez A. Does local recurrence affect the rate of distant metastases and survival in patients with early-stage breast carcinoma treated with breast-conserving therapy?. Cancer. 2003;97:910–919
  13. Meric F, Mirza NQ, Vlastos G, et al. Positive surgical margins and ipsilateral breast tumor recurrence predict disease-specific survival after breast-conserving therapy. Cancer. 2003;97:926–933
  14. Jobsen JJ, Van Der Palen J, Ong F, Meerwaldt JH. Differences in outcome for positive margins in a large cohort of breast cancer patients treated with breast-conserving therapy. Acta Oncol. 2007;46:172–180
  15. Malik HZ, George WD, Mallon EA, Harnett AN, Macmillan RD, Purushotham AD. Margin assessment by cavity shaving after breast-conserving surgery: analysis and follow-up of 543 patients. Eur J Surg Oncol. 1999;25:464–469
  16. Malik HZ, George WD, Mallon EA, Harnett AN, Macmillan RD, Purushotham AD. Tumour bed positivity predicts outcome after breast-conserving surgery. Br J Surg. 1997;84:1559–1562
  17. Smitt MC, Nowels K, Carlson RW, Jeffrey SS. Predictors of reexcision findings and recurrence after breast conservation. Int J Radiat Oncol Biol Phys. 2003;57:979–985
  18. Gwin JL, Eisenberg BL, Hoffman JP, Ottery FD, Boraas M, Solin LJ. Incidence of gross and microscopic carcinoma in specimens from patients with breast cancer after re-excision lumpectomy. Ann Surg. 1993;218:729–734
  19. Kotwall C, Ranson M, Stiles A, Hamann MS. Relationship between initial margin status for invasive breast cancer and residual carcinoma after re-excision. Am Surg. 2007;73:337–343
  20. Smitt MC, Horst K. Association of clinical and pathologic variables with lumpectomy surgical margin status after preoperative diagnosis or excisional biopsy of invasive breast cancer. Ann Surg Oncol. 2007;14:1040–1044
  21. Tartter PI, Kaplan J, Bleiweiss I, et al. Lumpectomy margins, re-excision, and local recurrence of breast cancer. Am J Surg. 2000;179:81–85
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PII: S0002-9610(09)00545-5

doi: 10.1016/j.amjsurg.2009.05.027

The American Journal of Surgery
Volume 198, Issue 6 , Pages 771-780 , December 2009

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