RELATIONSHIP BETWEEN SURGICAL MARGIN AND LOCAL RECURRENCE IN CONSERVATIVE TREATMENT OF BREAST CÂNCER
Keywords:
Breast câncer, Conservative treatment, Surgical margin, Local recurrenceAbstract
Increased risk of local recurrence of breast câncer in patients submitted to
conservative treatment may be associated with prognostic factors of the patients as
well as complementary measurements to surgical treatment. There is no agreement
among authors about the influence of these factors in the local recurrence rate, but
there is a consensus about the importance of the involvement of the surgical margin.
To establish a relationship between the extension of the margin of ressection free of
tumoral cells and local recurrence, a retrospective study of 219 patients submitted to
conservative treatment of breast câncer was done. Recurrence occurred in 17,8% of the
cases. A smaller rate of recurrence was seen in the following situations: surgical margins
of smaller risk (free margin larger than 0,5 cm), radiotherapy, boost and patients 45 years
and older; differences were not statistically significant. Other histological characteristics
of the tumor (size, histological degree, invasion, lymphonodes involvement, necrosis,
estrogen receptors) had no influence in the recurrence. Only the increase of the surgical
margin (reexcision) reduced significantly local relapse (p = 0,04), wich has direct
consequences in the extension of the margin free of tumor.
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References
1.CASOLO P, MOSCA D, AMOROTTIC et al. Our
experience in the surgical treatment of early breast
câncer. Results of a prospective study of 204 cases.
Ann Ital Chir 1997; 68; 195-204.
2.CHAPMAN JW, HANNA W, KAHN HJ et al.
Alternative multivariate modelling for time to local
recurrence for breast câncer patients receiving a
lumpectomy alone. Surg Oncol 1996; 5; 265-71.
3. CLARK RM, WHELAN T, LEVINE M et al.
Randomized clinicai trial of breast irradiation
following lumpectomy and axillary dissection for
node-negative breast câncer; an update. Ontario
Clinicai Oncology Group. J Natl Câncer Inst 1996;
88: 1659-64.4.DECKER T. RUHNKE M, SCHNEIDER W.
Standardized pathologic examination of breast
excision specimen. Relevance within an
interdisciplinary practice protocol for quality
management of breast saving therapy. Pathologe
1997; 18: 53-9.
5.DELANEY G. UNG O, CAHILL S et al. Ductal
carcinoma in situ. Part 2: Treatment. Aust N Z J
Surg 1997; 67: 157-65.
6.FISHER B, CONSTANTINO J, REDMOND C et
al. Lumpectomy compared with lumpectomy and
radiation therapy for the treatment of intraductal
breast câncer. N Engl J Med 1993; 328: 1581-6.
7.HOLLAND R. VELING SHJ, MRAVUNAC M et
al. Histologic multifocality of Tis, Tl-2 breast
carcinomas. Implications of clinicai trial of breast
conserving surgery. Câncer 1985; 56: 979-90.
8.MAGEE B. SWINDELL R, HARRIS M et al.
Prognostic factors for breast recurrence after
conservative breast surgery and radiotherapy:
results from a randomised trial. Radiother Oncol
1996; 39: 223-7
9.RENTON SC, GAZET JC, FORD HT et al. The
importance of the resection margin in conservative
surgery for breast câncer. Eur J Surg Oncol 1996;
22: 17-22.
10.SALVADORI B. Local recurrences after breastconserving treatment: an open problem. Semiri Surg
Oncol 1996; 12: 46-52.
11.SHIN E. TAKATSUKA Y, OKAMURA Y et al.
Strategy for breast conserving treatment - analysis
of recurrence and prognosis after breast conserving
treatment. Gan To Kagaku Ryoho 1996; 23: 92-9
(abstract).
12.SM1TTH MC, NOWELS KW, ZDEBLICK MJ et
al. The importance of the lumpectomy surgical
margin satus in long-term results of breast
conservation. Câncer 1995; 76: 259-67.
13.VERONESI U. BANFI A. SALVADORI B et al.
Breast conservation in the treatment of choice in
small breast câncer; long-term results of a randomized trial. Eur J Câncer 1990; 26: 668-70.
14.VERONESI U, LUINI A, VECCHIO MD et al.
Radiotherapy after breast preserving surgery in
woman with localized câncer of the breast. N Engl
J Med 1993; 328: 1587-91.
15.VERONESI U, VOLTERRANISS, LUINI A et al.
Quadrantectomy versus lumpectomy for small size
breast câncer. Eur J Câncer 1990; 26: 671-73.
16.VERONESI U, SALVADORI B, LUINI A et al.
Conservative treatment of early breast câncer.
Long-term results of 1.232 cases treated with
quadrantectomy, axillary dissection and
radiotherapy. Ann Surg 1990; 211: 250-9.
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Copyright (c) 2026 Jorge Villanova Biazus, Carlos Henrique Menke, José Antonio Cavalheiro, Eliane Goldberg Rabin, Chrystiane da Silva Marc, Clarissa Bacha Berti, Carolina Peukert
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