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Related Experiment Videos

Planned segmentectomy. A necessity for breast carcinoma

L Tafra1, J M Guenther, A E Giuliano

  • 1Joyce Eisenberg Keefer Breast Center, John Wayne Cancer Institute, St John's Hospital and Health Center, Santa Monica, Calif.

Archives of Surgery (Chicago, Ill. : 1960)
|September 1, 1993
PubMed
Summary

Excisional biopsy alone may not be sufficient for breast cancer treatment, as residual cancer tissue (RCT) was found in 76% of patients. Positive margins after segmentectomy significantly impacted recurrence-free survival, underscoring the need for planned surgical excision.

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Breast Cancer Research

Background:

  • Some surgeons consider excisional biopsy with negative margins adequate for breast carcinoma treatment, followed by axillary dissection and radiation.
  • The necessity of a planned surgical operation for breast carcinoma requires further investigation regarding residual cancer tissue (RCT) and positive margins.

Purpose of the Study:

  • To test the hypothesis that breast carcinoma necessitates a planned surgical operation.
  • To review the incidence of residual cancer tissue (RCT) and the significance of positive margins after excisional breast biopsy and segmentectomy.

Main Methods:

  • A retrospective review of segmentectomy specimens from 375 patients treated for breast carcinoma over 10 years.
  • Analysis of tumor status, including residual cancer tissue (RCT) and margin status, in relation to patient outcomes.

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  • Median follow-up of 32 months.

    • Main Results:

    • Residual cancer tissue (RCT) was present in 76% of segmentectomy specimens.
    • RCT-positive patients had larger median tumor diameters and were more likely to have positive axillary lymph nodes.
    • Recurrence-free survival was statistically related to segmentectomy margin status, not RCT presence in the specimen.

    Conclusions:

    • Diagnostic breast biopsy is insufficient for complete removal of malignant tissue.
    • Surgical procedures less than a planned excision may leave significant amounts of malignant tissue, impacting patient outcomes.