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Residual disease after re‐excision for tumour‐positive surgical margins in both ductal carcinoma in situ and invasive carcinoma of the breast: The effect of time
Author(s) -
van der Velden A.P. Schouten,
Van de Vrande Simon L.B.,
Boetes Carla,
Bult Peter,
Wobbes Theo
Publication year - 2007
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.20876
Subject(s) - medicine , ductal carcinoma , carcinoma , breast cancer , incidence (geometry) , carcinoma in situ , breast carcinoma , cancer , surgery , physics , optics
Abstract Background and Objectives To assess the effect of time on finding residual breast cancer in re‐excision specimens after non‐radical breast‐conserving surgery for both DCIS and invasive breast carcinoma. Methods 315 breast‐conserving surgical procedures with tumour‐positive margins were retrospectively reviewed. The significance of association between the presence of finding residual tumour in the re‐excision specimen and mean time interval was calculated with Student's t ‐test. A multivariate logistic regression model was used to assess the independent relative risk of time on presence of residual tumour. Results Residual tumour was found in 240 (76.2%) of the re‐excision specimens. For primary invasive carcinomas time was a risk‐reducing factor for finding residual disease (OR 0.89, 95% CI 0.82–0.98, P = 0.01). If invasive carcinoma was transected, the absence of residual disease was significantly related with a longer mean time interval (OR 0.98, 95% CI 0.95–0.99, P = 0.04). Conclusions An increased time interval between primary surgery and re‐excision for tumour‐positive surgical margins for invasive carcinoma is associated with a decreased incidence of finding residual tumour. This could be explained by inflammatory responses after surgical trauma. For DCIS there was no influence of time on finding residual tumour, which could be explained by a more protective microenvironment of DCIS or re‐growth of surviving malignant cells. J. Surg. Oncol. 2007;96:569–574. © 2007 Wiley‐Liss, Inc.