Close Surgical Margins Might Predict Return -- MEDICA - World Forum for Medicine

This year, more than 213,000 American women will learn they have breast cancer. Many women with early stage cancer prefer to have a lumpectomy, where only the cancerous lump is surgically removed, followed by radiation therapy and possibly chemotherapy. Women with a positive or close margin after a lumpectomy are often advised to undergo a re-excision.

In the study conducted at Fox Chase Cancer Center in Philadelphia, doctors divided 1,044 patients with stage I-II breast cancer with close or positive margins into three groups. Group 1 included 199 patients who did not have additional surgery, group 2 had 546 patients who had additional surgery proving they were free from cancer and group 3 included 299 patients who had additional surgery and showed evidence of additional cancer. All patients received radiation therapy.

After 10 years, the number of local recurrences was the same for women who had re-excision and for women who did not have re-excision (group 1 versus groups 2 and 3 together). This means the additional surgery was of no importance for the number of local recurrences. However, the result of the re-excision helped predict whether women would have their cancer return or not, thus enhancing their awareness.

“This study helps to clarify the role of a re-excision for a close or positive margin in women undergoing breast-conserving therapy for early-stage breast cancer,” said Derek Chism, M.D., a radiation oncologist now practicing at North Shore Medical Center in Peabody, Massachusetts.; Source: American Society for Therapeutic Radiology and Oncology