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Annals of Surgical Oncology

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01-11-2007 | Breast Oncology

The Effect of Multiple Reexcisions on the Risk of Local Recurrence After Breast Conserving Surgery

Authors: M. J. O’Sullivan, T. Li, G. Freedman, M. Morrow

Published in: Annals of Surgical Oncology | Issue 11/2007

Abstract

Background

Guidelines for breast conserving surgery (BCS) advise mastectomy if negative margins cannot be obtained after reasonable surgical attempts. This study examined the effect of multiple reexcisions on local recurrence (LR) and identified factors predictive of the need for multiple reexcisions.

Methods

2,770 patients undergoing BCS over 25 years were analyzed; 137 patients (group A) with two or more reexcisions, 1514 patients with one reexcision (group B), and 1119 patients who had no reexcision (group C). The median follow-up was 73 months.

Results

The five and ten-year actuarial LR rates for groups A, B, and C were 5.5%, 1.9%, 2.5%, and 10%, 5.7%, and 5.6%, respectively. The number of reexcisions did not predict for LR on multivariate analysis. Women <40 years underwent reexcision more frequently than other age groups. Patients with tumors detected by palpation alone made up 14% of the reexcision group versus 8% of the no reexcision group (p < 0.001). Patients with ductal carcinoma in situ and lobular carcinoma were more likely to require reexcision than those with ductal carcinoma. On multivariate analysis, younger age, detection by physical exam only, lobular histology, smaller tumor size, and the presence of extensive intraductal component (EIC) were highly significant predictors of the need for reexcision.

Conclusions

Multiple reexcisions do not impact on LR rates if negative margins are ultimately obtained. Conversion to mastectomy based solely on the number of excisions performed is not indicated. Subsets of patients more likely to require reexcision, who may be candidates for a larger initial resection, can be identified.

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Title: The Effect of Multiple Reexcisions on the Risk of Local Recurrence After Breast Conserving Surgery
Authors: M. J. O’Sullivan
T. Li
G. Freedman
M. Morrow
Publication date: 01-11-2007
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 11/2007
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-007-9523-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The Effect of Multiple Reexcisions on the Risk of Local Recurrence After Breast Conserving Surgery

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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