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Impact of atypical hyperplasia at margins of breast-conserving surgery on the recurrence of breast cancer

  • Shunrong Li
  • Jieqiong Liu
  • Yaping Yang
  • Yunjie Zeng
  • Heran Deng
  • Haixia Jia
  • Qian Li
  • Huiyi Feng
  • Yangyang Li
  • Erwei Song
  • Qiang LiuEmail author
  • Fengxi SuEmail author
Original Paper

Abstract

Purpose

Atypical hyperplasia (AH) is associated with a relatively higher risk of subsequent development of cancer. It remains controversial whether it is necessary to re-excise AH found at surgical margins during breast-conserving surgery (BCS). The aim of this study was to determine the impact of atypical ductal/lobular hyperplasia found at the margins during BCS on the prognosis of early-stage breast cancer patients.

Methods

A retrospective analysis comparing patients with AH and receiving no further surgical treatment (n = 233) to those without AH at the margins during BCS (n = 158) was performed.

Results

At a median follow-up of 76 months, the 5- and 8-year rates of ipsilateral breast tumor recurrence (IBTR) were 3.26 and 8.79 % for women with AH and 2.56 and 8.95 % for women without AH, respectively. There were no significant differences between the two groups in terms of IBTR (p = 0.803), distant-metastasis-free survival (DMFS) (p = 0.749), or overall survival (OS) (p = 0.165). Moreover, no significant differences were found in IBTR, DMFS, or OS between patients with severe atypical hyperplasia (n = 86) and those without AH (n = 158) (p = 0.81, 0.82, and 0.78, respectively). Additionally, young women or those with ductal carcinoma in situ or triple-negative breast cancer with AH involving margins did not have a higher IBTR rate when compared to similar patients without AH.

Conclusions

This study suggests that AH found at the margins during BCS does not increase the risk of subsequently developing an IBTR. There is not enough evidence for re-excision of AH found at the margins during BCS in patients with early-stage breast cancer.

Keywords

Atypical ductal/lobular hyperplasia Breast-conserving surgery Surgical margins Ipsilateral breast tumor recurrence 

Notes

Acknowledgments

This work was supported by the National Natural Science Foundation of China (Grant 30972785/H1604).

Conflict of interest

The authors have no conflict of interest to disclose.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Shunrong Li
    • 1
  • Jieqiong Liu
    • 1
  • Yaping Yang
    • 1
  • Yunjie Zeng
    • 2
  • Heran Deng
    • 1
  • Haixia Jia
    • 1
  • Qian Li
    • 1
  • Huiyi Feng
    • 1
  • Yangyang Li
    • 2
  • Erwei Song
    • 1
  • Qiang Liu
    • 1
    Email author
  • Fengxi Su
    • 1
    Email author
  1. 1.Breast Tumor CenterSun Yat-Sen Memorial HospitalGuangzhouChina
  2. 2.Department of Pathology, Sun Yat-Sen Memorial HospitalSun Yat-Sen UniversityGuangzhouChina

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