Breast cancer. Importance of adequate surgical excision prior to radiotherapy in the local control of breast cancer in patients treated conservatively

Arch Surg. 1992 Apr;127(4):411-5. doi: 10.1001/archsurg.1992.01420040053009.

Abstract

The extent of excision performed for mammary carcinoma prior to radiotherapy as a risk factor for local recurrence was studied in 503 patients. Three hundred twenty-three tumors (62%) were excised with a minimal rim of tissue (tumorectomy). One hundred forty-two patients (27%) had wide excision and 56 (11%) had quadrantectomy. Tumor stage, size, and radiation treatment were similar for all groups. Forty-one percent of tumorectomies had involved margins, and only 14% and 7% were involved in the wide excision and quadrantectomy groups, respectively. Local failure was 15% for tumorectomy, 7% for wide excision, and 5% for quadrantectomy. In T1 ductal carcinoma, only 4% of those with excisions greater than 5 cm had recurrences. Lesser excision had 20% recurrence. Extent of excision before radiotherapy is an important risk factor for recurrence. Failure was inversely proportional to the amount of breast tissue resected. Narrow excision should be discouraged since a larger tumor burden remains that may not be sterilized by radiation.

MeSH terms

  • Adult
  • Breast Neoplasms / radiotherapy
  • Breast Neoplasms / surgery*
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Mastectomy, Segmental / methods*
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology*
  • Retrospective Studies
  • Time Factors