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Published on: August 19, 2025
Excessive resections in breast-conserving surgery: a retrospective multicentre study.
Nicole Krekel1, Barbara Zonderhuis, Sandra Muller
1Surgical Oncology, VU University Medical Center, Amsterdam, The Netherlands. n.krekel@vumc.nl
The Breast Journal
|November 5, 2011
Summary
Breast-conserving surgery (BCS) often removes too much healthy tissue, impacting cosmetic results. This study found that calculated resection ratios indicate excessive tissue removal, even when clear margins are not achieved.
Area of Science:
- Oncology
- Surgical Oncology
- Breast Cancer Research
Background:
- Cosmetic outcomes in breast-conserving surgery (BCS) are significantly influenced by the volume of tissue resected.
- Achieving oncological control during BCS can sometimes result in the unnecessary removal of substantial amounts of healthy breast tissue.
Purpose of the Study:
- To evaluate the extent of excess tissue resection in BCS for breast cancer.
- To introduce and apply a calculated resection ratio (CRR) to quantify resection volume.
Main Methods:
- A retrospective analysis of 726 patients with T1-T2 invasive breast cancer undergoing BCS between 2006 and 2009.
- Pathology reports were reviewed to assess tumor characteristics, specimen size, and margin status.
- Optimal resection volume (ORV) and total resection volume (TRV) were calculated to determine the CRR (TRV/ORV).
Main Results:
- The median CRR was 2.5, indicating significant excess resection volume.
- Tumor palpability and stage influenced CRR, with nonpalpable and lower-stage tumors showing higher CRRs.
- A positive or focally positive margin rate of 21.1% was observed, with some cases of involved margins even at high CRRs (>4.0).
Conclusions:
- BCS frequently involves the excessive resection of healthy breast tissue.
- Current surgical practices do not consistently ensure clear oncological margins.
- Improvements in surgical techniques are needed to enhance accuracy and optimize tissue resection in BCS.
