Factors Influencing The Practice of Re-excision in Patiens Who Underwent Breast Conserving Surgery for Breast Cancer

Abstract

Objective: A significant proportion of patients undergoing breast-conserving surgery require re-excision for residual cancer. This study aims to determine the factors associated with residual tumor in patients undergoing breast conserving surgery, and to evaluate the follow-up results of the patients. Material and Methods: Patients underwent breast-conserving surgery in a 6-year period were included in this study. Patients were divided in 2 groups; no re-excision (Group A), and required re-excision (Group B). Patients who underwent mastectomy in the follow-up were excluded. Results: In this study, 190 patients were assessed; those 153 in Group A, and 37 in Group B. A total 192 masses were found; 154 in Group A, and 38 in Group B. The median follow-up time, and disease free survival were 9.2 (Inter Quantile Range [IQR]=5.9-11.1) years, and 8.8 (IQR=5.0-11.0) years respectively. There was no difference in disease free survival, and local recurrence between groups (p=0.246, and p=0.601; respectively). Axillary lymph node involvement, lymphovascular invasion, extensive intraductal companent, multifocality, large tumor diameter and younger age patients were higher in re-excision group. Multivariate anlysis identified, absence of lymphovascular invasion (Odds Ratio [OR]=0.05; %95Cl 0.01-0,44), and age >50 years (OR=0.17; %95Cl 0.04-0.73) were associated with lower re-excision requirement; however, tumor diameter >2 cm (OR=4.52;%95Cl 1.28-15.98) was associated with re-excision. Conclusion: There was no difference in disease free survival, and local recurrence between 2 groups. Patients should be informed for the risk of re-excision after initial breast conservig surgery and wider surgical excision or oncoplastic surgery should be performed in risky patients. Key Words: Breast conserving surgery, Re-excision, Early stage breast cancer.