Clinicopathologic factors associated with involved margins after breast-conserving surgery for invasive lobular carcinoma.

Clinical Breast Cancer
Eric J SilberfeinElizabeth A Mittendorf

Abstract

Obtaining negative margins for patients undergoing breast-conserving surgery (BCS) for invasive lobular carcinoma (ILC) can be difficult because of the unique histologic pattern of ILC. Our goal was to determine whether any specific patient- or disease-related factors influenced margin status. We retrospectively reviewed 211 patients with ILC treated from 1994 through 2004 to determine if specific clinical and pathologic factors influenced the ability to obtain negative margins. We identified 110 patients (52%) who underwent total mastectomy and 101 (48%) who underwent BCS. Among patients who underwent BCS, 50 (50%) had close or positive margins. Patients with close or positive margins were more likely to have architectural distortion on ultrasonography (vs. mass or calcifications; P = .049), to have undergone excisional biopsy (vs. core or fine-needle aspiration; P = .008), and to have associated ductal carcinoma in situ (P = .021). On multivariate analysis, only biopsy method retained significance (P = .006). Core needle biopsy is the preferred method of diagnostic biopsy before surgical intervention. With appropriate patient selection, most patients with early-stage ILC can undergo successful BCS.

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Citations

Dec 10, 2013·American Journal of Surgery·Laurel SootHeidi D Nelson
Oct 12, 2014·The Breast : Official Journal of the European Society of Mastology·N BigliaP Sismondi
May 29, 2016·Pathology, Research and Practice·Matthias ChristgenHans Kreipe
Oct 1, 2010·Annals of Surgical Oncology·Nimmi AroraMonica Morrow

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