The impact of margin status in breast-conserving therapy for lobular carcinoma is age related

Eur J Surg Oncol. 2010 Feb;36(2):176-81. doi: 10.1016/j.ejso.2009.06.003. Epub 2009 Jul 31.

Abstract

Purpose: The aim is to look at the impact of margin status and outcome of invasive lobular carcinoma (ILC) treated with breast-conserving therapy (BCT).

Methods: This manuscript describes an analysis on 330 BCT in 318 patients with ILC.

Results: The 12-year local relapse free survival (LRFS) is 89%. In multivariate analysis, positive margin status, age>50 years, contra lateral breast cancer, and adjuvant systemic therapy were significant predictors of local relapse free survival. In a separate analysis limited to a positive margin for invasive carcinoma or carcinoma in situ, only a positive margin for invasive carcinoma was a significant predictor of local relapse free survival. This was limited to women<or=50 years. The 12-year disease-specific survival (DSS) was 85%. In multivariate Cox regression analysis grade 3 compared to grade 2 (HR 7.2), and a tumour size of pT2 (HR 2.5) were significant independent predictors of disease-specific survival (DFS). These factors were also relevant for distant metastasis-free survival (DMFS) and disease-free survival (DFS).

Conclusions: Positive margins for invasive carcinoma seem to be a strong predictor for local recurrence in particular for women<or=50-years. Our study showed grade 3 and tumour size to be strong predictors of DMFS, DFS, and DSS. Margin status was not.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / surgery*
  • Carcinoma in Situ / pathology
  • Carcinoma in Situ / surgery
  • Carcinoma, Lobular / mortality
  • Carcinoma, Lobular / pathology*
  • Carcinoma, Lobular / secondary
  • Carcinoma, Lobular / surgery*
  • Disease-Free Survival
  • Female
  • Humans
  • Mastectomy, Segmental*
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local
  • Prognosis
  • Survival Rate