Re-excision of margins before breast radiation - Diagnostic or therapeutic?

被引:23
作者
Chism, Derek B.
Freedman, Gary M.
Li, Tianyu
Anderson, Penny R.
机构
[1] Fox Chase Canc Ctr, Dept Radiat Oncol, Philadelphia, PA 19111 USA
[2] Fox Chase Canc Ctr, Dept Biostat, Philadelphia, PA 19111 USA
[3] N Shore Med Ctr, Dept Radiat Oncol, Peabody, MA USA
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2006年 / 65卷 / 05期
关键词
breast cancer; radiotherapy; surgical margin; 20-YEAR FOLLOW-UP; CONSERVATIVE SURGERY; CONSERVING SURGERY; STAGE-I; POSITIVE MARGINS; LOCAL RECURRENCE; CANCER PATIENTS; MASTECTOMY; RADIOTHERAPY; CARCINOMA;
D O I
10.1016/j.ijrobp.2006.02.017
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To identify factors in breast cancer patients that predict the pathologic results of re-excision for close or positive margins and to determine the effect on local control. Methods and Materials: We divided 1,044 patients with Stage I-II breast cancer with a close (<= 2 mm) or positive margin after initial excision into three groups. Group 1 included 199 patients without additional excision, Group 2 included 546 patients with re-excision found to be free of cancer, and Group 3 included 299 patients with re-excision and residual cancer. All patients were treated with radiotherapy with a median follow-up of 6.7 years. Results: The 10-year local control rate was 95% for Group 1 and 94% for Groups 2 and 3 (p = 0.788). Of the 846 patients, 65% had no residual disease on re-excision and 35% did have residual tumor. The factors significantly associated with positive re-excision findings were initial positive margins, positive nodes, Stage T2 tumor, and an extensive intraductal component. The 10-year local control rate was 95% for Group 2 vs. 91% for Group 3 (p = 0.038). Conclusion: The low recurrence rates seen in this study suggest that selected patients with non-negative margins, particularly those with a low risk of having residual disease at re-excision, may be treated with radiotherapy. (c) 2006 Elsevier Inc.
引用
收藏
页码:1416 / 1421
页数:6
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