, Volume 15, Issue 8, pp 2352-2353
Date: 01 Feb 2008

Lumpectomy and Partial Breast Irradiation - Risks and Benefits for Early Breast Cancer

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Breast-conserving surgery followed by radiation therapy is the standard local treatment of early primary breast cancer.1 Radiation therapy limited to the part of the breast closest to the site of the excised tumor (accelerated partial breast irradiation, APBI) might be beneficial for these patients, but definitive results of ongoing trials should be awaited. Partial breast intraoperative radiation (IORT) has recently been developed to further improve the results of partial irradiation. Given that tumor-negative margins are required for IORT, Schiller et al.2 considered how to identify and select patients for IORT by predicting those with tumor-free excision margins.

The authors2 analyzed data from 708 patients who underwent 730 lumpectomies and found a 17% rate of positive margins at first resection. They could accurately (98%) predict negative margin status for the subset of patients older than 50 years with a preoperative core needle biopsy (CNB) showing invasive cancer less than 3 cm