Predictors of Residual Disease in Repeat Excisions for Lumpectomies with Margins Less Than 0.1 cm

Extent of Margin Involvement, Lymphovascular Invasion, and Extensive Intraductal Component Predict for Residual Disease After Wide Local Excision for Breast Cancer

“…23,26,29 This might have been related to the growth pattern of such tumors. Invasive lobular carcinomas have a greater tendency to be multifocal and radiologically occult compared with the more common ductal carcinomas.…”

“…26 Others have likewise reported an increased risk of residual disease when an EIC is present. 12,23,27 Extensive DCIS changes beyond the invasive tumor might suggest a "field change" effect in the breast, affecting a wider area than clinically apparent, which might then result in surgeons underestimating the extent of resection required. However, although additional tumor foci are reportedly more frequent in the presence of EIC, the local failure rates were not greater if negative margins were achieved and postoperative radiation was completed.…”

“…This rate was significantly lower than that reported in another study. 23 Although this accounts for the lower local recurrence rates associated with close margins, it should also caution against considering all close margins adequate. The likelihood of residual tumor also correlated positively with the number of radial margins affected; > 50% of those with 2 affected radial margins had residual disease compared with 36% with only a single margin affected.…”

Surgical margins in breast cancer management

“…De plus, les marges d'exé rè se doivent ê tre é valué es en fonction des autres facteurs de risque de persistance de maladie ré siduelle : ainsi Rodriguez et al retrouvaient un impact entre pré sence de maladie ré siduelle et marges non envahies mais proches (≥ 1 mm), de la taille de l'invasion initiale et de la pré sence de carcinome in situ au sein de la tumeur initiale [41]. Cependant, d'autres é quipes ne retrouvent pas de lien entre marges et pré sence de maladie ré siduelle.…”

“…De plus, la dé finition des marges d'exé rè se reste é galement floue et variable selon les é quipes entre marges envahies et marges insuffisantes, allant de 1 à 10 mm, influen-ç ant les indications de reprise chirurgicale [28,29,41].…”