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Predictors of resectability in breast-conserving therapy
Michelle G Rath1, Joerg Heil, Christoph Domschke
1Department of Gynecology and Obstetrics, University of Heidelberg, Voßstraße 9, 69115 Heidelberg, Germany.
Background:
Our goal is to identify subgroups of women undergoing breast-conserving therapy (BCT) who are at increased risk for requiring a secondary surgical procedure, and to identify tumor and patient profiles that will allow surgeons to anticipate the need for taking larger margins when removing the tumor.
Methods:
One hundred female patients who had palpable, invasive carcinomas of the breast, and had undergone a primary BCT, were included in the study. Of these, all women (n = 25) who had incomplete resections, or questionable margins of resection, had to undergo re-excisions.
Results:
Patients who had multifocal disease, accompanying ductal carcinoma in situ, involvement of regional lymph nodes, high-grade breast cancer (Grade 3 vs. 1/2), lympho-vascular invasion or negative hormone-receptor-status, were significantly more likely to have undergone incomplete removal of tumor tissue-these patients thus required a secondary surgery.
Conclusion:
The clinical and pathological predictors described above indicate that surgery in breast cancer patients meeting these criteria require larger safety margins to minimize the incidence rate of re-excision at a later date.