Local recurrence after partial mastectomy: relation to initial surgical margins

Area of Science:

• Oncology
• Surgical Oncology
• Radiation Oncology

Background:

• Local recurrence (LR) after partial mastectomy (PM) is often linked to insufficient surgical margins.
• The role of initial margin status in patients receiving postoperative radiation therapy (RT) requires further investigation.

Purpose of the Study:

• To assess the association between initial surgical margins and ipsilateral LR in patients undergoing PM and RT.
• To evaluate the impact of re-excision on LR rates in this patient cohort.

Main Methods:

• Retrospective review of patients who underwent initial PM between 2003 and 2008.
• Data collected included initial margin status, re-excision status, and ipsilateral LR.
• Follow-up data were analyzed to determine LR rates based on margin status.

Main Results:

• 166 out of 712 patients (27.8%) had positive or <1 mm initial margins.
• The LR rate was significantly higher for patients with initial margins <1 mm (4.2%) compared to those with margins ≥1 mm (0.7%) (P = .006).
• Re-excision was performed for all positive margins and 20.2% of <1 mm margins.

Conclusions:

• The study reports lower LR rates than traditionally observed.
• The necessity of re-excision to achieve 1-5 mm margins warrants re-evaluation as it may not influence LR rates.
• Optimizing initial margin assessment may be crucial for managing local recurrence risk.