Factors Associated with Re-excision after Breast-Conserving Surgery for Early-Stage Breast Cancer

• Published in: Journal of breast cancer Vol. 15; no. 4; pp. 412 - 419
• Main Authors: Jung, Woohyun, Kang, Eunyoung, Kim, Sun Mi, Kim, Dongwon, Hwang, Yoonsun, Sun, Young, Yom, Cha Kyong, Kim, Sung-Won
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Breast Cancer Society 01.12.2012; 한국유방암학회
• Subjects: Original; 일반외과학; Safety of margin; Breast neoplasms; Segmental mastectomy
• ISSN: 1738-6756; 2092-9900
• DOI: 10.4048/jbc.2012.15.4.412

Re-excisions after breast-conserving surgery (BCS) for breast cancer cause delays in the adjuvant treatment, increased morbidity, and leads to poor aesthetic results. Thus, efforts to reduce the re-excision rate are essential. This study aimed to conclusively determine the re-excision rate and the factors associated with re-excision after BCS. We retrospectively reviewed the medical records and pathological reports of 711 cases that underwent BCS for early-stage breast cancer. Univariate and multivariate analyses were performed. Of the 711 cases of BCS, 71 (10.0%) required re-excision. Patients in the re-excision group were younger than those in the no re-excision group. Non-palpable lesions, the presence of non-mass-like enhancement at magnetic resonance imaging, multifocality, the presence of a ductal carcinoma in situ (DCIS) component, and an infiltrative tumor border were also significantly associated with re-excision. Multivariate analysis indicated that younger age, non-palpable lesions, multifocal lesions, and the presence of a DCIS component were factors which were independently associated with re-excision. Tumors located in the lower inner quadrant had a relatively high involved resection margin rate as well as a narrow resection margin width, especially at the superior and medial margins. Lateral margins showed a tendency toward a wider resection margin width. At our institution, the rate of re-excision was low despite the lack of an intraoperative frozen section. Patients with non-palpable or multifocal tumors, a DCIS component, or those who were younger than 50 years were more likely to require re-excision after BCS. These factors should be considered when planning surgical management of early-stage breast cancer. Positive resection margin rates and margin widths differed on a directional basis based on tumor location, and these differences were considerable.