Re-excision After Breast Conservation Surgery – Our Breast Unit experience
Published Date: 23rd December 2019
Publication Authors: Pushdary KH, Atherton J, Ray A, Jois RHS
Background
The benefit of re-excision surgery for involved margin after BCS among the patient receiving adjuvant radiotherapy is unclear. Omission of re-excision surgery for selected patients with focally involved margin after BCS did not alter DFS and OS. Knowing the biology of cancer may assist to select patients benefiting with re-excision surgery.
Methods
Patients undergoing re-excision surgery after BCS (2009-17) included in this study. Redo specimen histology for residual tumour, local recurrence, survival benefits and disease free survival are the end points. This retrospective data is categorized and analysed using SPSS 22.
Result(s)
Number of re-excision procedure 104 (6.8%). The median age 59 yrs, No residual invasive cancer 64 patients (61.9%).85 patients(84%) had BCS with therapeutic intention. Completion mastectomy performed in 22 patients, 6 of them (22%) developed local recurrence. Variables achieving significance (p<0.05); Significant factors for Local Recurrence(LR) are Nodal status, nodal stage, neo-adjuvant chemotherapy; tumour grade; Main significant variables associated with Distant Recurrence (DR) were nodal stage, triple negative status, and neo-adjuvant chemotherapy. Biological variables associated with poor Overall Survival (OS) are tumour grade, triple negative hormonal status and neo-adjuvant chemotherapy.
Conclusion(s)
Biology of cancer determined the long-term outcomes i.e., LR, Distant recurrence and survival. Adjuvant radiotherapy offers similar benefits as redo surgery without second surgery for subgroup of patients. We believe further research is required to identify patients who would benefit from Re-excision surgery.
Pushdary, K; Atherton, J; Ray, A; Jois, R. (2019). Re-excision After Breast Conservation Surgery – Our Breast Unit experience . European Journal of Surgical Oncology. 45 (11), 2201
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