Lumpectomy specimen margins are not reliable in predicting residual disease in breast conserving surgery

American Journal of Surgery

Volumn 210, Issue 1, 2015, Pages 93-98

  Tang, Rong ^a,b   Coopey, Suzanne B ^a   Specht, Michelle C ^a   Lei, Lan ^a   Gadd, Michele A ^a   Hughes, Kevin S ^a   Brachtel, Elena F ^a   Smith, Barbara L ^a  

^a MASSACHUSETTS GENERAL HOSPITAL   (United States)

^b CENTRAL SOUTH UNIVERSITY   (China)

Author keywords

Breast cancer; Lumpectomy margins; Residual disease; Shaved cavity margins

Indexed keywords

ADULT; AGED; ARTICLE; BREAST CARCINOMA; CANCER RECURRENCE; COMPARATIVE STUDY; DIAGNOSTIC ACCURACY; DIAGNOSTIC TEST ACCURACY STUDY; DISTANT METASTASIS; FALSE NEGATIVE RESULT; FALSE POSITIVE RESULT; FEMALE; FOLLOW UP; HISTOPATHOLOGY; HUMAN; INTRADUCTAL CARCINOMA; LOCAL METASTASIS; LUMPECTOMY MARGIN; MAJOR CLINICAL STUDY; MALE; MINIMAL RESIDUAL DISEASE; ONCOLOGICAL PARAMETERS; PARTIAL MASTECTOMY; PREDICTIVE VALUE; PRIORITY JOURNAL; RELIABILITY; RETROSPECTIVE STUDY; SENSITIVITY AND SPECIFICITY; SHAVED CAVITY MARGIN; TISSUE SECTION; TUMOR VOLUME; BREAST NEOPLASMS; EVALUATION STUDY; MIDDLE AGED; NEOPLASM, RESIDUAL; PATHOLOGY; REPRODUCIBILITY; SEGMENTAL MASTECTOMY; VERY ELDERLY;

ADULT; AGED; AGED, 80 AND OVER; BREAST NEOPLASMS; FEMALE; HUMANS; MASTECTOMY, SEGMENTAL; MIDDLE AGED; NEOPLASM, RESIDUAL; PREDICTIVE VALUE OF TESTS; REPRODUCIBILITY OF RESULTS;

EID: 84931573584     PISSN: 00029610     EISSN: 18791883     Source Type: Journal    
DOI: 10.1016/j.amjsurg.2014.09.029     Document Type: Article

References (36)

1. R. Arriagada, M.G. Le, and F. Rochard Conservative treatment versus mastectomy in early breast cancer: patterns of failure with 15 years of follow-up data J Clin Oncol 14 1996 1558 1564
2. U. Veronesi, N. Cascinelli, and L. Mariani Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer N Engl J Med 347 2002 1227 1232
3. B. Fisher, S. Anderson, and J. Bryant Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer N Engl J Med 347 2002 1233 1241
4. M.C. Smitt, K. Nowels, and R.W. Carlson Predictors of reexcision findings and recurrence after breast conservation Int J Radiat Oncol Biol Phys 57 2003 979 985
5. P.I. Tartter, J. Kaplan, and I. Bleiweiss Lumpectomy margins, re-excision, and local recurrence of breast cancer Am J Surg 179 2000 81 85
6. N. Houssami, P. Macaskill, and M.L. Marinovich Meta-analysis of the impact of surgical margins on local recurrence in women with early-stage invasive breast cancer treated with breast-conserving therapy Eur J Cancer 46 2010 3219 3232
7. M.J. Silverstein, M.D. Lagios, and S. Groshen The influence of margin width on local control of ductal carcinoma in situ of the breast N Engl J Med 340 1999 1455 1461
8. D.E. Wazer, R.K. Schmidt-Ulrich, and R. Ruthazer Factors determining outcome for breast-conserving irradiation with margin-directed dose escalation to the tumor bed Int J Radiat Oncol Biol Phys 40 1998 851 858
9. M.S. Moran, S.J. Schnitt, and A.E. Giuliano Society of Surgical Oncology-American Society for Radiation Oncology consensus guideline on margins for breast-conserving surgery with whole-breast irradiation in stages I and II Invasive breast cancer Ann Surg Oncol 21 2014 704 716
10. S. Coopey, B.L. Smith, and S. Hanson The safety of multiple re-excisions after lumpectomy for breast cancer Ann Surg Oncol 18 2011 3797 3801
11. J.A. Guidroz, G. Larrieux, and J. Liao Sampling of secondary margins decreases the need for re-excision after partial mastectomy Surgery 150 2011 802 809
12. C.S. Kaufman, L. Jacobson, and B. Bachman Intraoperative ultrasonography guidance is accurate and efficient according to results in 100 breast cancer patients Am J Surg 186 2003 378 382
13. R.J. Gray, C. Salud, and K. Nguyen Randomized prospective evaluation of a novel technique for biopsy or lumpectomy of nonpalpable breast lesions: radioactive seed versus wire localization Ann Surg Oncol 8 2001 711 715
14. R. Tang, S. Coopey, and J. Buckley Evaluation of shaved cavity margins with micro-computed tomography: a novel method for intraoperative lumpectomy margin status assessment in breast Cancer patients Breast J 19 2013 485 489
15. T.M. Allweiss, Z. Kaufman, and S. Lelcuk A prospective, randomized, controlled, multicenter study of a real-time, intraoperative probe for positive margin detection in breast-conserving surgery Am J Surg 196 2008 483 489
16. G.R. Gibson, B.A. Lesnikoski, and J. Yoo A comparison of ink-directed and traditional whole-cavity re-excision for breast lumpectomy specimens with positive margins Ann Surg Oncol 8 2001 693 704
17. H.H. Luu, C.N. Otis, and W.P. Reed Jr. The unsatisfactory margin in breast cancer surgery Am J Surg 178 1999 362 366
18. W.C. Dooley, and J. Parker Understanding the mechanisms creating false positive lumpectomy margins Am J Surg 190 2005 606 608
19. D. Cao, C. Lin, and S.H. Woo Separate cavity margin sampling at the time of initial breast lumpectomy significantly reduces the need for re-excisions Am J Surg Pathol 29 2005 1625 1632
20. C.D. Scopa, P. Aroukatos, and A.C. Tsamandas Evaluation of margin status in lumpectomy specimens and residual breast carcinoma Breast J 12 2006 150 153
21. M.J. Silverstein, E.D. Gierson, and W.M.J. Colburn Can intraductal breast carcinoma be excised completely by local excision? Clinical and pathologic predictors Cancer 73 1994 2985 2989
22. A. Ratanawichitrasin, L.A. Rybicki, and E. Steiger Predicting the likelihood of residual disease in women treated for ductal carcinoma in situ J Am Coll Surg 188 1999 17 21
23. S.J. Schnitt, and J.L. Connolly Processing and evaluation of breast excision specimens: a clinically-oriented approach Am J Clin Pathol 98 1992 125 137
24. M. Keskek, M. Kothari, and B. Ardehali Factors predisposing to cavity margin positivity following conservation surgery for breast cancer Eur J Surg Oncol 30 2004 1058 1064
25. R.R. Patel, T. Li, and E.A. Ross The effect of simultaneous peripheral excision in breast conservation upon margin status Ann Surg Oncol 17 2010 2933 2939
26. T.L. Huston, R. Pigalarga, and M.P. Osborne The influence of additional surgical margins on the total specimen volume excised and the reoperative rate after breast-conserving surgery Am J Surg 192 2006 509 512
27. A.D. Jenkinson, R.A. Al-Mufti, and Y. Mohsen Does intraductal breast cancer spread in a segmental distribution? An analysis of residual tumor burden following segmental mastectomy using tumour bed biopsies Eur J Surg Oncol 27 2001 21 25
28. M.A. Molina, S. Snell, and D. Franceschi Breast specimen orientation Ann Surg Oncol 16 2009 285 288
29. M. Singh, G. Singh, and K.T. Hogan The effect of intraoperative specimen inking on lumpectomy re-excision rates World J Surg Oncol 8 2010 4
30. D. Carter Margins of "lumpectomy" for breast cancer Hum Pathol 17 1986 330 332
31. A.J. Guidi, J.L. Connolly, and J.R. Harris The relationship between shaved margin and inked margin status in breast excision specimens Cancer 79 1997 1568 1573
32. D.E. Wazer, R.K. Schmidt-Ullrich, and C.H. Schmid The value of breast lumpectomy margin assessment as a predictor of residual tumor burden Int J Radiat Oncol Biol Phys 38 1997 291 299
33. J.A. Margenthaler, F. Gao, and V.S. Klimberg Margin index: a new method for prediction of residual disease after breast-conserving surgery Ann Surg Oncol 17 2010 2696 2701
34. A.C. Neuschatz, T. DiPetrillo, and M. Steinhoff The value of breast lumpectomy margin assessment as a predictor of residual tumor burden in ductal carcinoma in situ of the breast Cancer 94 2002 1917 1924
35. S.B. Coopey, J.M. Buckley, and B.L. Smith Lumpectomy cavity shaved margins do not impact re-excision rates in breast cancer patients Ann Surg Oncol 18 2011 3036 3040
36. J.A. Mook, R. Klein, and A. Kobbermann Volume of excision and cosmesis with routine cavity shave margins technique Ann Surg Oncol 19 2012 886 891