The effect of simultaneous peripheral excision in breast conservation upon margin status

Area of Science:

• Oncology
• Surgical Pathology
• Breast Surgery

Background:

• Negative margins in breast conservation therapy (BCT) are essential for reducing local recurrence risk.
• Current BCT excision techniques include single lumpectomy or central segment with peripheral segments (PSs).
• Limited data exists comparing these techniques for margin status outcomes.

Purpose of the Study:

• To compare the effectiveness of single lumpectomy versus simultaneous peripheral segment excision in achieving negative margins during BCT.
• To identify factors influencing positive margin rates in BCT.

Main Methods:

• Retrospective review of BCT procedures for invasive breast cancer.
• Data collected included patient presentation, tumor characteristics, surgical technique, specimen volume, and margin status.
• Comparison of single-segment excision versus multi-peripheral segment (PS) excision.

Main Results:

• Smaller tumor size, lack of extensive intraductal component (EIC), and a greater number of simultaneously resected PSs were associated with lower rates of positive margins.
• Increased number of PSs removed did not significantly increase total resected specimen volume.
• Residual tumor was found in 49.2% of PSs even with a compromised primary segment margin.

Conclusions:

• Simultaneous excision of multiple peripheral segments (PSs) may improve negative margin rates in BCT.
• This technique may be advantageous due to reduced likelihood of positive margins and potential avoidance of pathologic artifact.
• Smaller tumors and absence of EIC further decrease positive margin risk.