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Ipsilateral breast tumor reappearance in patients treated with conservative surgery after primary chemotherapy. The role of surgical margins on outcome
Author(s) -
Gentilini Oreste,
Intra Mattia,
Gandini Sara,
Peruzzotti Giulia,
Winnikow Erik,
Luini Alberto,
Veronesi Paolo,
Galimberti Viviana,
Goldhirsch Aron,
Veronesi Umberto
Publication year - 2006
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.20583
Subject(s) - medicine , mastectomy , breast cancer , incidence (geometry) , cumulative incidence , surgery , chemotherapy , breast conserving surgery , surgical margin , modified radical mastectomy , cancer , resection , physics , transplantation , optics
Background and Objectives To evaluate the ipsilateral breast tumor reappearance (IBTR) rate after breast conservative surgery (BCS) following primary chemotherapy (PC) and to assess whether positive margins affects IBTR rate and overall survival (OS). Methods Three hundred nine women candidates for mastectomy received PC before surgery. One hundred ninety‐five patients (63.1%) underwent BCS and 114 patients (36.9%) a modified radical mastectomy. Results After a median follow‐up of 41 months (range 7–90), 13 patients of the 195 treated with BCS had an IBTR (6.7%), 6 patients had a regional relapse (3.1%), 28 women had distant metastases (14.4%). Twenty‐three patients died of breast cancer (11.8%). Twenty‐four patients treated with BCS had positive margins (12.3%). At 3 years, the crude cumulative incidence of local recurrence was 4.7% in women with negative margins, and 13.3% in women with positive margins ( P = 0.05). Cumulative incidence of distant metastases was similar in patients with positive and negative margins ( P = 0.16) and there was no significant difference in terms of OS according to the margin status ( P = 0.577). Conclusions BCS after PC has an acceptable rate of IBTR. After a short follow‐up, the presence of positive margins does not affect OS. J. Surg. Oncol. 2006;94:375–379. © 2006 Wiley‐Liss, Inc.