Clinicopathologic factors associated with involved margins after breast-conserving surgery for invasive lobular carcinoma

Clin Breast Cancer. 2010 Feb;10(1):52-8. doi: 10.3816/CBC.2010.n.007.


Introduction: Obtaining negative margins for patients undergoing breast-conserving surgery (BCS) for invasive lobular carcinoma (ILC) can be difficult because of the unique histologic pattern of ILC. Our goal was to determine whether any specific patient- or disease-related factors influenced margin status.

Patients and methods: We retrospectively reviewed 211 patients with ILC treated from 1994 through 2004 to determine if specific clinical and pathologic factors influenced the ability to obtain negative margins.

Results: We identified 110 patients (52%) who underwent total mastectomy and 101 (48%) who underwent BCS. Among patients who underwent BCS, 50 (50%) had close or positive margins. Patients with close or positive margins were more likely to have architectural distortion on ultrasonography (vs. mass or calcifications; P = .049), to have undergone excisional biopsy (vs. core or fine-needle aspiration; P = .008), and to have associated ductal carcinoma in situ (P = .021). On multivariate analysis, only biopsy method retained significance (P = .006).

Conclusion: Core needle biopsy is the preferred method of diagnostic biopsy before surgical intervention. With appropriate patient selection, most patients with early-stage ILC can undergo successful BCS.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use
  • Biopsy, Needle
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / surgery*
  • Carcinoma, Lobular / drug therapy
  • Carcinoma, Lobular / pathology*
  • Carcinoma, Lobular / surgery*
  • Combined Modality Therapy
  • Female
  • Humans
  • Mastectomy, Segmental*
  • Middle Aged
  • Neoadjuvant Therapy
  • Neoplasm Staging


  • Antineoplastic Agents