J Breast Cancer.  2012 Dec;15(4):412-419. 10.4048/jbc.2012.15.4.412.

Factors Associated with Re-excision after Breast-Conserving Surgery for Early-Stage Breast Cancer

• Jung W
• Kang E
• Kim SM
• Kim D
• Hwang Y
• Sun Y
• Yom CK
• Kim SW

• KMID: 2286438
• DOI: http://doi.org/10.4048/jbc.2012.15.4.412

Abstract

PURPOSE
Re-excisions after breast-conserving surgery (BCS) for breast cancer cause delays in the adjuvant treatment, increased morbidity, and leads to poor aesthetic results. Thus, efforts to reduce the re-excision rate are essential. This study aimed to conclusively determine the re-excision rate and the factors associated with re-excision after BCS.
METHODS
We retrospectively reviewed the medical records and pathological reports of 711 cases that underwent BCS for early-stage breast cancer. Univariate and multivariate analyses were performed.
RESULTS
Of the 711 cases of BCS, 71 (10.0%) required re-excision. Patients in the re-excision group were younger than those in the no re-excision group. Non-palpable lesions, the presence of non-mass-like enhancement at magnetic resonance imaging, multifocality, the presence of a ductal carcinoma in situ (DCIS) component, and an infiltrative tumor border were also significantly associated with re-excision. Multivariate analysis indicated that younger age, non-palpable lesions, multifocal lesions, and the presence of a DCIS component were factors which were independently associated with re-excision. Tumors located in the lower inner quadrant had a relatively high involved resection margin rate as well as a narrow resection margin width, especially at the superior and medial margins. Lateral margins showed a tendency toward a wider resection margin width.
CONCLUSION
At our institution, the rate of re-excision was low despite the lack of an intraoperative frozen section. Patients with non-palpable or multifocal tumors, a DCIS component, or those who were younger than 50 years were more likely to require re-excision after BCS. These factors should be considered when planning surgical management of early-stage breast cancer. Positive resection margin rates and margin widths differed on a directional basis based on tumor location, and these differences were considerable.

Keyword

Breast neoplasms; Safety of margin; Segmental mastectomy

MeSH Terms

Breast
Breast Neoplasms
Carcinoma, Intraductal, Noninfiltrating
Frozen Sections
Humans
Magnetic Resonance Imaging
Mastectomy, Segmental
Medical Records
Multivariate Analysis
Retrospective Studies

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