The impact of a focally positive resection margin on the local control in patients treated with breast-conserving therapy

Seho Park, Hyung Seok Park, Seung Il Kim, JaSeung Koo, Byeongwoo Park, Kyong Sik Lee

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective: The aim of the study was to investigate the parameters affecting positive margin and the impact of positive margin on outcomes after breast-conserving therapy in patients with breast cancer. Methods: Characteristics and survival of 705 patients attempted breast-conserving therapy between January 1994 and December 2004 were retrospectively analyzed using x2 tests, the Kaplan-Meier methods and multivariate analyses. Results: Ninety-five (13.5%) showed positive margins at initial resection. Among them, 28 (4.0%) had negative margin on the initial frozen section; however, they finally turned out a focally positive margin with intraductal carcinoma on the permanent pathology. Positive margin at initial resection was significantly associated with lobular histology (P = 0.001), four or more involved lymph nodes (P = 0.015) and the presence of extensive intraductal component (P < 0.001). A focally positive margin did not influence local (P = 0.250; 95% confidence interval, 0.612-6.592) or regional failure (P = 0.756; 95% confidence interval, 0.297-5.311). Patients with a focally positive margin showed an advanced nodal stage and received a higher dose of irradiation and more systemic therapy. Nodal involvements were the most significant factor for locoregional failure. Conclusions: Although the achievement of negative margins is the best way to reduce local failure, patients with a focally positive margin and favorable risk factors such as node negativity and older age could have an option of close follow-up with adequate boost irradiation and adjuvant therapy instead of conversion to total mastectomy.

Original languageEnglish
Article numberhyr018
Pages (from-to)600-608
Number of pages9
JournalJapanese Journal of Clinical Oncology
Volume41
Issue number5
DOIs
Publication statusPublished - 2011 May 1

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Breast
Simple Mastectomy
Confidence Intervals
Carcinoma, Intraductal, Noninfiltrating
Kaplan-Meier Estimate
Frozen Sections
Therapeutics
Histology
Multivariate Analysis
Lymph Nodes
Pathology
Breast Neoplasms
Survival
Margins of Excision

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

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title = "The impact of a focally positive resection margin on the local control in patients treated with breast-conserving therapy",
abstract = "Objective: The aim of the study was to investigate the parameters affecting positive margin and the impact of positive margin on outcomes after breast-conserving therapy in patients with breast cancer. Methods: Characteristics and survival of 705 patients attempted breast-conserving therapy between January 1994 and December 2004 were retrospectively analyzed using x2 tests, the Kaplan-Meier methods and multivariate analyses. Results: Ninety-five (13.5{\%}) showed positive margins at initial resection. Among them, 28 (4.0{\%}) had negative margin on the initial frozen section; however, they finally turned out a focally positive margin with intraductal carcinoma on the permanent pathology. Positive margin at initial resection was significantly associated with lobular histology (P = 0.001), four or more involved lymph nodes (P = 0.015) and the presence of extensive intraductal component (P < 0.001). A focally positive margin did not influence local (P = 0.250; 95{\%} confidence interval, 0.612-6.592) or regional failure (P = 0.756; 95{\%} confidence interval, 0.297-5.311). Patients with a focally positive margin showed an advanced nodal stage and received a higher dose of irradiation and more systemic therapy. Nodal involvements were the most significant factor for locoregional failure. Conclusions: Although the achievement of negative margins is the best way to reduce local failure, patients with a focally positive margin and favorable risk factors such as node negativity and older age could have an option of close follow-up with adequate boost irradiation and adjuvant therapy instead of conversion to total mastectomy.",
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The impact of a focally positive resection margin on the local control in patients treated with breast-conserving therapy. / Park, Seho; Park, Hyung Seok; Kim, Seung Il; Koo, JaSeung; Park, Byeongwoo; Lee, Kyong Sik.

In: Japanese Journal of Clinical Oncology, Vol. 41, No. 5, hyr018, 01.05.2011, p. 600-608.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The impact of a focally positive resection margin on the local control in patients treated with breast-conserving therapy

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AU - Park, Hyung Seok

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AU - Park, Byeongwoo

AU - Lee, Kyong Sik

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N2 - Objective: The aim of the study was to investigate the parameters affecting positive margin and the impact of positive margin on outcomes after breast-conserving therapy in patients with breast cancer. Methods: Characteristics and survival of 705 patients attempted breast-conserving therapy between January 1994 and December 2004 were retrospectively analyzed using x2 tests, the Kaplan-Meier methods and multivariate analyses. Results: Ninety-five (13.5%) showed positive margins at initial resection. Among them, 28 (4.0%) had negative margin on the initial frozen section; however, they finally turned out a focally positive margin with intraductal carcinoma on the permanent pathology. Positive margin at initial resection was significantly associated with lobular histology (P = 0.001), four or more involved lymph nodes (P = 0.015) and the presence of extensive intraductal component (P < 0.001). A focally positive margin did not influence local (P = 0.250; 95% confidence interval, 0.612-6.592) or regional failure (P = 0.756; 95% confidence interval, 0.297-5.311). Patients with a focally positive margin showed an advanced nodal stage and received a higher dose of irradiation and more systemic therapy. Nodal involvements were the most significant factor for locoregional failure. Conclusions: Although the achievement of negative margins is the best way to reduce local failure, patients with a focally positive margin and favorable risk factors such as node negativity and older age could have an option of close follow-up with adequate boost irradiation and adjuvant therapy instead of conversion to total mastectomy.

AB - Objective: The aim of the study was to investigate the parameters affecting positive margin and the impact of positive margin on outcomes after breast-conserving therapy in patients with breast cancer. Methods: Characteristics and survival of 705 patients attempted breast-conserving therapy between January 1994 and December 2004 were retrospectively analyzed using x2 tests, the Kaplan-Meier methods and multivariate analyses. Results: Ninety-five (13.5%) showed positive margins at initial resection. Among them, 28 (4.0%) had negative margin on the initial frozen section; however, they finally turned out a focally positive margin with intraductal carcinoma on the permanent pathology. Positive margin at initial resection was significantly associated with lobular histology (P = 0.001), four or more involved lymph nodes (P = 0.015) and the presence of extensive intraductal component (P < 0.001). A focally positive margin did not influence local (P = 0.250; 95% confidence interval, 0.612-6.592) or regional failure (P = 0.756; 95% confidence interval, 0.297-5.311). Patients with a focally positive margin showed an advanced nodal stage and received a higher dose of irradiation and more systemic therapy. Nodal involvements were the most significant factor for locoregional failure. Conclusions: Although the achievement of negative margins is the best way to reduce local failure, patients with a focally positive margin and favorable risk factors such as node negativity and older age could have an option of close follow-up with adequate boost irradiation and adjuvant therapy instead of conversion to total mastectomy.

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