How close surgical margins predict the outcome in breast cancer

Reported by Susan Aldridge, PhD, medical journalist

Surgical margins resulting from lumpectomy play a role in predicting whether breast cancer will return.
Many women with early breast cancer opt for a lumpectomy, which is removal of the tumor alone rather than the whole breast. This is generally followed up with radiotherapy and maybe chemotherapy too. In lumpectomy, the surgeon also removes a margin of healthy tissue around the tumor. Examination of this margin is an important part of the therapy. The margin is classified as positive if it contains cancer cells, negative if it does not, and close if it is not clear whether it is positive or negative. Women with a positive or close margin might need more surgery - known as re-excision.

In a new study, researchers at Fox Chase Cancer Center in Philadelphia looked at the outcome for 1,044 women with close or positive margins, dividing them into three groups. Group 1 patients did not have re-excision, Group 2 had re-excision that showed they were free of cancer, Group 3 had re-excision showing they had residual cancer. After ten years, the number of local recurrences was the same for those who did and did not have re-excision. Women in Group 2 had local control of their disease of about 95 per cent and those in Group 3 had local control of 91 per cent. The study underlines the importance of the close margin in predicting the outcome in early breast cancer.

Source
International Journal of Radiation Oncology Biology Physics 1st August 2006