| Role for intraoperative margin assessment in patients undergoing breast-conserving surgery. | |
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MedLine Citation:
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PMID: 17260108 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Positive/close margins are associated with higher in-breast failure rates after breast-conserving surgery (BCS). We investigated whether intraoperative margin assessment aids in obtaining negative margins, and to evaluate the local control thus achieved. METHODS: Between 1994 and 1996, 264 patients underwent BCS for stages 0-III breast cancer [invasive, n = 200; ductal carcinoma in situ (DCIS), n = 64]. Intraoperative margin assessment included gross tissue inspection, specimen radiography, with or without frozen section. RESULTS: Ninety-two patients (46%) with invasive cancer and 24 (38%) with DCIS had positive/close margins on the permanent section analysis of their initial surgical specimens. Fifty-eight patients (29%) with invasive cancer and six (9%) with DCIS had initial positive/close margins, and were rendered margin-negative by intraoperative analysis and immediate re-excision. Final margins on permanent pathology were positive/close in 52 patients (20%): 34 patients (17%) with invasive cancer and 18 patients (28%) with DCIS. By multivariate analysis, excisional biopsy for diagnosis, larger tumor size, and multifocality were associated with final positive/close margins. Of these 52 patients, 23 underwent a second operation to achieve widely negative margins (13 completion mastectomies, 10 re-excisions). The 5-year ipsilateral breast recurrence-free survival rates after BCS and radiation were 99% for invasive cancer (n = 167) and 100% for DCIS (n = 27). CONCLUSIONS: Intraoperative assessment of margins assisted in identifying positive/close margins and allowed over a quarter of the patients to be rendered margin-negative with intraoperative re-excision at their original operation. This approach resulted in excellent local control in patients treated with BCS and radiation. |
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Authors:
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Neslihan Cabioglu; Kelly K Hunt; Aysegul A Sahin; Henry M Kuerer; Gildy V Babiera; S Eva Singletary; Gary J Whitman; Merrick I Ross; Frederick C Ames; Barry W Feig; Thomas A Buchholz; Funda Meric-Bernstam |
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Publication Detail:
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Type: Journal Article Date: 2007-01-28 |
Journal Detail:
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Title: Annals of surgical oncology Volume: 14 ISSN: 1068-9265 ISO Abbreviation: Ann. Surg. Oncol. Publication Date: 2007 Apr |
Date Detail:
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Created Date: 2007-04-02 Completed Date: 2007-08-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9420840 Medline TA: Ann Surg Oncol Country: United States |
Other Details:
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Languages: eng Pagination: 1458-71 Citation Subset: IM |
Affiliation:
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Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, 77030, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Breast Neoplasms / pathology, surgery*, therapy Carcinoma, Ductal, Breast / pathology, surgery*, therapy Carcinoma, Lobular / pathology, surgery*, therapy Combined Modality Therapy Female Humans Intraoperative Period Mastectomy, Segmental* Neoplasm Staging Neoplasm, Residual / pathology, surgery, therapy Prognosis Retrospective Studies Survival Rate Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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