Use of pathologic factors to assist in establishing adequacy of excision before radiotherapy in patients treated with breast-conserving therapy

International Journal of Radiation Oncology, Biology, Physics
Frank ViciniLarry L Kestin

Abstract

We reviewed our experience in patients with early-stage breast carcinoma treated with breast-conserving therapy (BCT) to identify pathologic factors useful in defining the adequacy of excision before radiotherapy (RT). All slides from 607 consecutively treated cases of Stage I-II breast carcinoma were reviewed by one pathologist. Numerous pathologic factors were evaluated for their association with ipsilateral breast failure (IBF). Margin distance was classified as negative, near (<0.50 low-power field), or positive. The amount of carcinoma near the final margin was measured as the width of invasive carcinoma and number of ducts with carcinoma in situ near the margin and divided into three groups: near-least, near-intermediate, and near-greatest amount. The median follow-up was 8.5 years. Patients with negative, near-least, near-intermediate, and near-greatest amount of carcinoma near the margin, and positive final margins had a 12-year IBF rate of 9%, 6%, 18%, 24%, and 30%, respectively. On multivariate analysis, only the amount of carcinoma near the margin was independently associated with IBF (p <0.001). To help explain these observations, 441 initial and reexcision specimens were examined. The amount of carcinoma near the i...Continue Reading

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Citations

Feb 9, 2006·Current Oncology Reports·Alphonse G Taghian, Abram Recht
Jul 6, 2012·The New England Journal of Medicine·Monica MorrowStuart J Schnitt
Sep 19, 2012·Indian Journal of Medical and Paediatric Oncology : Official Journal of Indian Society of Medical & Paediatric Oncology·Anusheel MunshiUNKNOWN other Locoregional Panel Members
Apr 22, 2014·The Journal of Surgical Research·Claire EdwardsCarla Fisher
Aug 19, 2006·ANZ Journal of Surgery·Astrid V Cuncins-HearnGuy Maddern
Jul 31, 2007·Journal of the American College of Surgeons·UNKNOWN American College of Radiology

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