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01-02-2016 | Breast Oncology

Excising Additional Margins at Initial Breast-Conserving Surgery (BCS) Reduces the Need for Re-excision in a Predominantly African American Population: A Report of a Randomized Prospective Study in a Public Hospital

Authors: Veronica Jones, MD, Jared Linebarger, MD, Sebastian Perez, MPH, Sheryl Gabram, MD, MBA, Joel Okoli, MD, Harvey Bumpers, MD, Brian Burns, Marina Mosunjac, MD, Monica Rizzo, MD

Published in: Annals of Surgical Oncology | Issue 2/2016

Abstract

Background

Margin status is an important prognostic factor for local recurrence after breast conserving surgery (BCS) for breast cancer. We designed a prospective randomized trial to evaluate the effect of shave margins on positive margins and locoregional recurrence (LRR).

Methods

Patients were randomized to BCS or BCS with resection of 5 additional margins (BCS + M). Tumor margins were classified as negative [>2 mm for ductal carcinoma in situ (DCIS); >1 mm for invasive carcinoma] based on guidelines at the time of accrual.

Results

A total of 75 patients with stage 0–III breast cancer (76 samples) were randomized, mean age 59.6 years with median follow-up 39.5 months. Overall, 21 patients (27.6 %) had positive margins: 14 had undergone BCS and 7 BCS + M (p = 0.005). Of the 21 patients with positive margins, 19 had DCIS on final pathology (OR 7.56; 95 % CI 1.52–37.51).All patients with positive margins were offered re-excision; 11 had negative final margins after re-excision surgery. Overall, 6 patients (8.3 %) developed LRR with recurrence being more common in the BCS group when compared with the BCS + M group (17.2 vs 2.3 %; p = 0.025).

Conclusions

Taking additional cavity shave margins at the time of initial excision resulted in a reduction in positive margin rate, a decrease in return to operating room for re-excision, and lower LRR.

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Title: Excising Additional Margins at Initial Breast-Conserving Surgery (BCS) Reduces the Need for Re-excision in a Predominantly African American Population: A Report of a Randomized Prospective Study in a Public Hospital
Authors: Veronica Jones, MD
Jared Linebarger, MD
Sebastian Perez, MPH
Sheryl Gabram, MD, MBA
Joel Okoli, MD
Harvey Bumpers, MD
Brian Burns
Marina Mosunjac, MD
Monica Rizzo, MD
Publication date: 01-02-2016
Publisher: Springer US
Published in: Annals of Surgical Oncology / Issue 2/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-015-4789-4

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Excising Additional Margins at Initial Breast-Conserving Surgery (BCS) Reduces the Need for Re-excision in a Predominantly African American Population: A Report of a Randomized Prospective Study in a Public Hospital

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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