Outcomes in breast cancer patients relative to margin status after treatment with breast-conserving surgery and radiation therapy: the University of Pennsylvania experience

Peterson, Michael E.; Schultz, Delray; Reynolds, Carol; Solin, Lawrence J.

doi:10.1016/s0360-3016(98)00519-7

Cited by 129 publications

(60 citation statements)

References 28 publications

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“…Tumor size was found to be associated with positive surgical margins by Peterson et al, [5] Park et al [6] and Tartter et al [7] by univariate analysis. Tartter et al [7] and Luu et al [8] demonstrated by multivariate analysis also, that tumor size showed a significant correlation with surgical margins.…”

Section: Discussionmentioning

confidence: 93%

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Feasibility of breast conservation surgery in locally advanced breast cancer downstaged by neoadjuvant chemotherapy: A study in mastectomy specimens using simulation lumpectomy

et al. 2005

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Section: Discussionmentioning

confidence: 93%

“…[5][6][7][8][13][14][15] Those which were significant included younger age, DCIS, extensive intraductal component, positive family history, lymphovascular invasion, axillary node positivity status and large tumor size.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of breast conservation surgery in locally advanced breast cancer downstaged by neoadjuvant chemotherapy: A study in mastectomy specimens using simulation lumpectomy

et al. 2005

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“…16,20 Other studies have assessed surgical margin according to distance from the cut edge, 17 but these distances varied by Ͻ 1 mm, Ͻ 2mm, or Ͻ 10mm. 14,19,39 In the current study, the majority of close margins (Յ 5 mm from the cut edge of the specimen) were regarded as positive margins. Although judgment of margin status depends on each institution, meticulous histologic assessment was done in all institutions.…”

Section: Discussionmentioning

confidence: 99%

“…28,29 Considering that late distant metastases are not likely to develop so frequently after mastectomy, IBTR may be a cause of DM in such cases. Up to now, many investigators thought that IBTR was only a marker for DM 19,20,23,24 because many cases of IBTR that subsequently developed DM had more aggressive primary tumor characteristics. Recently, however, it appears that additional radiation may lead to a survival benefit, suggesting IBTR may, in part, be a cause of DM, especially in cases of IBTR who develop late DM.…”

Section: Figurementioning

confidence: 99%

Ipsilateral breast tumor recurrence (IBTR) after breast‐conserving treatment for early breast cancer

Komoike

Akiyama

Iino

et al. 2005

Cancer

160

103

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BACKGROUNDThe clinical features of ipsilateral breast tumor recurrence (IBTR) after breast conserving therapy (BCT) for early stage breast cancer were analyzed from long‐term follow‐up of BCT in Japan. The purpose of this study was to clarify risk factors of IBTR and the impact of IBTR on development of distant metastases in this ethnic group.METHODSPatients (N = 1901)with unilateral breast cancer ≤ 3 cm in diameter who underwent BCT at 18 Japanese major breast cancer treatment institutes from 1986 to 1993 were registered in this study. Survival rates, the incidences of IBTR and distant metastases, and annual rates of IBTR and distant metastases after primary operation were calculated by the Kaplan–Meier method. A Cox proportional hazards model was used to estimate the risks of IBTR and distant metastases. A Cox model was also used to estimate the risks of distant metastases after IBTR in the group of IBTR.RESULTSAt a median follow‐up time of 107 months, the 10‐year overall and disease‐free survival rates were 83.9% and 77.8%, respectively. The 10‐year cumulative rates of IBTR were 8.5% in the patients with postoperative irradiation and 17.2% in the patients without irradiation. The 10‐year cumulative distant metastasis rate was 10.9%. On multivariate analysis, young age, positive surgical margin, and omission of radiation therapy were significant predictors of IBTR. In addition, IBTR significantly correlated with subsequent distant metastases (hazard ratio, 3.93; 95% confidence interval, 2.676–5.771; P < 0.0001). Among patients who developed IBTR, initial lymph node metastases and short interval to IBTR were significant risk factors for subsequent distant metastasis.CONCLUSIONSYoung age, positive surgical margin, and omission of radiation therapy seemed to be important factors in relation to local control. The authors' results also indicated that IBTR is significantly associated with subsequent distant metastasis. Patients with positive nodal status at primary operation or with short interval from primary operation to IBTR are at especially high risk of distant metastasis. It remains unclear, however, whether IBTR is an indicator or a cause of subsequent distant metastases. Cancer 2006. © 2005 American Cancer Society.

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“…In the majority of the reported series, positive margins of resection have been associated with an increased risk of breast recurrence, although the magnitude has varied considerably (Table 10). 48,[53][54][55][56][57][58][59][60][61] The variation in these results may be related to the extent of the surgical resection for the primary tumor, the presence or absence of an EIC, the definition of a positive margin, the number of margins that are positive, and the extent of the margin positivity.…”

Section: Elements Of the Breast Physical Exammentioning

confidence: 99%

Standard for Breast Conservation Therapy in the Management of Invasive Breast Carcinoma

Morrow

Strom

Bassett

et al. 2002

CA: A Cancer Journal for Clinicians

298

165

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Multidisciplinary guidelines for management of invasive breast carcinoma from the American College of Radiology, the American College of Surgeons, the College of American Pathology, and the Society of Surgical Oncology have been updated to reflect the continuing advances in the diagnosis and treatment of invasive breast cancer. The guidelines provide a framework for clinical decision‐making for patients with invasive breast carcinoma based on review of relevant literature and include information on patient selection and evaluation, technical aspects of surgical treatment, techniques of irradiation, and follow‐up care.

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Outcomes in breast cancer patients relative to margin status after treatment with breast-conserving surgery and radiation therapy: the University of Pennsylvania experience

Cited by 129 publications

References 28 publications

Feasibility of breast conservation surgery in locally advanced breast cancer downstaged by neoadjuvant chemotherapy: A study in mastectomy specimens using simulation lumpectomy

Feasibility of breast conservation surgery in locally advanced breast cancer downstaged by neoadjuvant chemotherapy: A study in mastectomy specimens using simulation lumpectomy

Ipsilateral breast tumor recurrence (IBTR) after breast‐conserving treatment for early breast cancer

Standard for Breast Conservation Therapy in the Management of Invasive Breast Carcinoma

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