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OBJECTIVE To examine the effect of microscopic tumor at the margins on local recurrence after breast-conserving surgery for invasive carcinoma. METHODS Retrospective review of patients treated with surgical resection followed by radiation therapy. METHODS A university-based radiation department and a community-based cancer referral center. METHODS A consecutive series of 272 women treated between 1982 and 1990. METHODS Local recurrence according to the histopathologic status of excised margins and the total dose of radiation. RESULTS During a mean follow-up period of 48 months, the overall rate of local recurrence was 6.3%. Local recurrence was more frequent (P = .0001) in patients with histologically positive margins (18.2%) than in those with unknown margins (7.1%) or negative margins (3.7%). In the 44 patients with positive margins, the local recurrence rate was 8.3% after radiation doses of 66 Gy or more compared with 21.9% following lower doses. CONCLUSIONS Microscopic involvement of resection margins increases the risk of local recurrence following breast-conserving surgery for invasive carcinoma. Therefore, every effort should be made to achieve negative margins intraoperatively.
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Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke,
