Influence of tumour bed assessment on local recurrence following breast-conserving surgery for breast cancer

Aims:To assess the impact of adopting a policy of tumour bed assessment with selective re-excision in patients undergoing breast-conserving surgery for breast cancer.Methods:Tumour bed assessment was introduced in our institution in 1988. Patients treated prior to 1988 (125 patients) were compared w...

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Bibliographic Details
Published in:European journal of surgical oncology 1999-06, Vol.25 (3), p.265-268
Main Authors: Malik, H.Z., Purushotham, A.D., Mallon, E.A., George, W.D.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Axilla
Biological and medical sciences
Breast Neoplasms - mortality
Breast Neoplasms - pathology
Breast Neoplasms - surgery
breast-conserving surgery
Female
Follow-Up Studies
Gynecology. Andrology. Obstetrics
Humans
Incidence
local recurrence
Lymphatic Metastasis
Mammary gland diseases
Mastectomy, Segmental
Medical sciences
Middle Aged
Neoplasm Recurrence, Local
Survival Analysis
Tumors
tumour bed positivity
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Summary:Aims:To assess the impact of adopting a policy of tumour bed assessment with selective re-excision in patients undergoing breast-conserving surgery for breast cancer.Methods:Tumour bed assessment was introduced in our institution in 1988. Patients treated prior to 1988 (125 patients) were compared with patients treated post-1988 (239 patients) for clinico-pathological factors, surgical and adjuvant therapy. Outcome measures were examined at afixed5-year follow-up period for each patient.Results:There were a greater number of small, node-negative, oestrogen receptor tumours post-1988, probably due to the influence of the National Breast Screening Programme. There was also a difference in the prescription of adjuvant systemic therapy between the two cohorts. The incidence of tumour bed positivity was 30.5%. The re-excision rate was 16.4%. There was a significant fall in the incidence of local recurrence from pre-1988 (15.7%) to post-1988 (2.5%).Conclusion:By adopting a policy of tumour bed assessment with selective re-excision, a low local recurrence rate has been achieved. The improvement in systemic recurrence and breast cancer-related death rate are mainly secondary to other factors.
ISSN:0748-7983
1532-2157
DOI:10.1053/ejso.1998.0639