If at First or Second You Don’t Succeed: Mastectomy?
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In this issue of Annals of Surgical Oncology, Menses et al.1 reviewed factors associated with local recurrence after breast-conservation surgery in 459 patients treated for invasive and in situ carcinoma of the breast. Overall, the authors reported a local recurrence in 28 patients (6%) at 5 years. Nearly 50% of patients (n = 229) in this series had at least 1 re-excision, and only 22 patients had 2 or more re-excisions. The local recurrence rate in the 22 patients re-excised 2 or more times was 13.4%, compared with 5.6% of patients with 1 re-excision and 3.5% without a re-excision at 5 years. On multivariate analysis, the authors also found, in addition to the number of re-excisions, that age younger than 50 years and omission of radiotherapy were also independent factors associated with an increased local recurrence rate.
The results of this study are intuitive to the surgical oncologist who routinely performs breast-conservation surgery. Many of us will continue to perform multiple...
KeywordsLocal Recurrence Local Recurrence Rate Partial Breast Irradiation Conformal Radiation Treatment Local Breast Cancer Recurrence
- 1.Menses TS, Tartter PI, Bleiweiss I, et al. The consequence of multiple re-excisions to obtain clear lumpectomy margins in breast cancer patients. Ann Surg Oncol (in press)Google Scholar
- 3.Morrow M, Strom EA, Bassett LW, et al. Standard for breast conservation therapy in the management of invasive breast carcinoma. CA Cancer J Clin 2002;52:277–300Google Scholar