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

 Seho Park  ;  Hyung Seok Park  ;  Kyong Sik Lee  ;  Byeong-Woo Park  ;  Ja Seung Koo  ;  Seung Il Kim 
 Japanese Journal of Clinical Oncology, Vol.41(5) : 600-608, 2011 
Journal Title
 Japanese Journal of Clinical Oncology 
Issue Date
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 χ(2) 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.
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실)
Yonsei Authors
구자승(Koo, Ja Seung) ; 김경식(Kim, Kyung Sik) ; 김성훈(Kim, Sung Hoon) ; 김승일(Kim, Seung Il) ; 박병우(Park, Byeong Woo) ; 박세호(Park, Se Ho) ; 박형석(Park, Hyung Seok)
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