Original Research

Breast-conserving therapy for breast carcinoma: Margins, re-excision and recurrence rates

Pueya R. Nashidengo, Eugenio Panieri, Lydia Cairncross
South African Journal of Oncology | Vol 2 | a31 | DOI: https://doi.org/10.4102/sajo.v2i0.31 | © 2018 Pueya R. Nashidengo, Eugenio Panieri, Lydia Cairncross | This work is licensed under CC Attribution 4.0
Submitted: 21 October 2017 | Published: 19 February 2018

About the author(s)

Pueya R. Nashidengo, Department of Surgery, Groote Schuur Hospital, University of Cape Town, South Africa
Eugenio Panieri, Oncology and Endocrine Surgical Unit, Groote Schuur Hospital, University of Cape Town, South Africa
Lydia Cairncross, Oncology and Endocrine Surgical Unit, Groote Schuur Hospital, University of Cape Town, South Africa


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Abstract

Background: Breast-conserving therapy (BCT) is a wide local excision of the tumour usually followed by radiation treatment to the breast. It is the mainstay treatment for carefully selected patients with early breast cancer. There has not been a formal audit to review BCT outcomes in our unit.
Objectives: To determine excision margins, re-excision and local recurrence rates.
Methods: A histopathological and oncology records’ review of BCT patients from 01 January 2006 to 31 December 2010. The health faculty’s ethics committee granted approval. Data points accrued included age, histological tumour size, nodal status, tumour type, oestrogen receptor status, lymphovascular invasion, volume of specimen, margin status, management of involved or close margins, radiotherapy, ipsilateral breast recurrence rate and duration of follow-up.
Results: A total of 192 patients had BCT. The mean age is 53 years. A median of 229.5 cm3 volume of specimen was excised. Infiltrating ductal carcinoma was the commonest histological type at 79.1%. The resection margin status: positive margins rate 15.1%, close margin rate 8.3% (≤ 1 mm), 35.9% (1 mm–5 mm), 23.4% (6 mm–10 mm) and 17.2% (> 10 mm). Overall, 27 (14.0%) patients underwent a second procedure, 16 (8.3%) patients had re-excision and 10 (5.2%) patients had a mastectomy. At a median follow-up of 60 months, a total of 11 (6.8%) patients had recurrence. Median time to recurrence is 39 months.
Conclusion: Positive and close margin re-excision and local recurrence rates in our unit are acceptable and comparable to other units in South Africa and internationally.

Keywords

Breast-Conserving Therapy; wide local excision; resection margins

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