Breast Conserving Surgery

  • BBSG – Brazilian Breast Study Group


Breast conserving surgery (BCS), also known as quadrantectomy, sectorectomy, or lumpectomy, consists of surgical removal of the primary tumor, with negative margins and whole breast radiotherapy (RT). The addition of RT to conservative surgery reduces the local recurrence rate by 50%, with an impact on mortality at 15 years, according to a meta-analysis by the Early Breast Cancer Trialists Collaborative Group (EBCTCG), showing that the omission of radiotherapy in BCS is not recommended.


Breast conserving surgery BCS Margins Radiation therapy Local recurrence 

Recommended Reading

  1. 1.
    Barrio AV, Morrow M. Appropriate margin for lumpectomy excision of invasive breast cancer. Chin Clin Oncol. 2016;5(3):35. Review of the literature on available data regarding the relationship between margin status and local control for invasive breast cancer and the impact of molecular subtypes and systemic therapy on local control. CrossRefGoogle Scholar
  2. 2.
    Bodilsen A, Bjerre K, Offersen BV, Vahl P, Amby N, Dixon JM, Ejlertsen B, Overgaard J, Christiansen P. Importance of margin width in breast-conserving treatment of early breast cancer. J Surg Oncol. 2016;113(6):609–15. A cohort study with 11,900 women, with a follow-up period of 4.9 years, with LR rates of 2.4% in 5 years and 5.9% in 9 years. It showed increased LR rates significantly associated with young age (<50 years), estrogen receptor negative, grade III, more than 4 positive lymph nodes and re-intervention. CrossRefGoogle Scholar
  3. 3.
    Houssami N, Macaskill P, Marinovich ML, Morrow M. The association of surgical margins and local recurrence in women with early-stage invasive breast cancer treated with breast-conserving therapy: a meta-analysis. Ann Surg Oncol. 2014;21(3):717–30. Meta-analysis on margins in invasive carcinomas. 33 studies, with 28,162 patients, found 1,506 cases of LR (5.3%), with a follow-up of 79.2 months. There was no difference in LR considering the distances of the margins of 1, 2 and 5 mm. CrossRefGoogle Scholar
  4. 4.
    Houssami N, Turner RM, Morrow M. Meta-analysis of pre-operative magnetic resonance imaging (MRI) and surgical treatment for breast cancer. Breast Cancer Res Treat. 2017. Revisions on mammary staging with MRI with 19 studies concluded that preoperative MRI is associated with an increased indication of ipsilateral mastectomy and contralateral prophylactic mastectomy. Google Scholar
  5. 5.
    Marinovich ML, Azizi L, Macaskill P, Irwig L, Morrow M, Solin LJ, Houssami N. The association of surgical margins and local recurrence in women with ductal carcinoma in situ treated with breast-conserving therapy: a meta-analysis. Ann Surg Oncol. 2016;23(12):3811–21. A meta-analysis of 20 studies evaluating patients with ductal carcinoma in situ and observing the LR according to the state of the margins. It has been shown that margins wider than 2 mm are not related to lower LR rates. CrossRefGoogle Scholar

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • BBSG – Brazilian Breast Study Group
    • 1
  1. 1.BBSGSao PauloBrazil

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