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Volume 18, Issue 1 (Iranian Journal of Breast Diseases 2025)
ijbd 2025, 18(1): 133-145 |
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Ethics code: IR.ACECR.IBCRC.REC.1398.019
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Hashemi H, olfatbakhsh A, Moghadam S, Haghighat S. Surgical Margin Status and Local Recurrence in Breast-Conserving Surgery. ijbd 2025; 18 (1) :133-145
URL: http://ijbd.ir/article-1-1146-en.html
URL: http://ijbd.ir/article-1-1146-en.html
1- Breast disease Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
2- Quality of Life Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran ,sha_haghighat@yahoo.com.
2- Quality of Life Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran ,
Abstract: (334 Views)
Introduction: Breast-conserving surgery (BCS) followed by radiotherapy is the standard treatment for early stages of breast cancer. Margin status may significantly impact local recurrence (LR) in patients treated with BCS. The present study aimed to evaluate the relationship between margin status and LR.
Materials and Methods: In a retrospective longitudinal study, we analyzed medical records of 1,716 breast cancer patients treated by BCS at Motamed Cancer Institute (MCI) from 2001 to 2020. The collected data included pathology report data, such as tumor size, axillary involvement, molecular subtype, margin status, histological grade, lymphovascular invasion, and LR, as well as demographic characteristics. Margins were defined as close if surgical margins were less than 2 mm, as free if surgical margins were higher than 2 mm, and as positive if malignant cells were present in one of the tissue edges.
Results: It was found that 133 (7.7%) patients had LR. The mean follow-up time was 46.79 (±34.47) months. The multivariate logistic regression analysis showed that the presence of involved margins (OR=9.27; 95% CI: 2.08-41.36) and stage III of cancer (OR=6.69; 95% CI: 1.95-22.95) were correlated with LR.
Conclusions: The findings indicated a low LR rate for breast cancer. Margin involvement and stage III breast cancer were correlated with high LR risk and should be considered for these patients before surgery to reduce the LR rate. Prospective trials and long-term follow-up are required to confirm these results.
Type of Study: Research |
Subject:
Diagnosis, treatment, rehabilitation
Received: 2024/10/14 | Accepted: 2025/02/6 | Published: 2025/03/19
Received: 2024/10/14 | Accepted: 2025/02/6 | Published: 2025/03/19
References
1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2021;71(3):209-49. doi: 10.3322/caac.21660. [DOI:10.3322/caac.21660] [PMID]
2. Akbari M, Abachizadeh K, Khayamzadeh M, Tabatabaee M, Esnaashari F, Motlagh A. Iran cancer report. Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Qom: Darolfekr. 2008.
3. Ditsatham C, Somwangprasert A, Watcharachan K, Wongmaneerung P, Khorana J. Factors affecting local recurrence and distant metastases of invasive breast cancer after breast-conserving surgery in Chiang Mai University Hospital. Breast Cancer: Targets and Therapy. 2016;8:47. doi: 10.2147/BCTT.S99184. [DOI:10.2147/BCTT.S99184] [PMID] []
4. Bernardi S, Bertozzi S, Londero AP, Gentile G, Angione V, Petri R. Influence of surgical margins on the outcome of breast cancer patients: a retrospective analysis. World journal of surgery. 2014;38(9):2279-87. doi: 10.1007 / s00268-014-2596-x. [DOI:10.1007/s00268-014-2596-x] [PMID]
5. Behm EC, Beckmann KR, Dahlstrom JE, Zhang Y, Cho C, Stuart-Harris R, et al. Surgical margins and risk of locoregional recurrence in invasive breast cancer: an analysis of 10-year data from the Breast Cancer Treatment Quality Assurance Project. The Breast. 2013;22(5):839-44. doi: 10.1016/j.breast.2013.02.018. [DOI:10.1016/j.breast.2013.02.018] [PMID]
6. Lovrics PJ, Cornacchi SD, Farrokhyar F, Garnett A, Chen V, Franic S, et al. The relationship between surgical factors and margin status after breast-conservation surgery for early stage breast cancer. The American journal of surgery. 2009;197(6):740-6. doi: 10.1016/j.amjsurg.2008.03.007. [DOI:10.1016/j.amjsurg.2008.03.007] [PMID]
7. Boundouki G, Wong Sik Hee JR, Croghan N, Stocking K, Pieri A, Critchley A, et al. Comparing long-term local recurrence rates of surgical and non-surgical management of close anterior margins in breast conserving surgery. Breast cancer research and treatment. 2019;176(2):311-9. doi: 10.1007/s10549-019-05242-8. [DOI:10.1007/s10549-019-05242-8] [PMID]
8. Moran MS, Schnitt SJ, Giuliano AE, Harris JR, Khan SA, Horton J, et al. Society of Surgical Oncology-American Society for Radiation Oncology consensus guideline on margins for breast-conserving surgery with whole-breast irradiation in stages I and II invasive breast cancer. International Journal of Radiation Oncology Biology Physics. 2014;32(14):1507-15. doi: 10.1200/JCO.2013.53.3935. [DOI:10.1200/JCO.2013.53.3935] [PMID]
9. Wang S-Y, Chu H, Shamliyan T, Jalal H, Kuntz KM, Kane RL, et al. Network meta-analysis of margin threshold for women with ductal carcinoma in situ. Journal of the National Cancer Institute. 2012;104(7):507-16. doi: 10.1093/jnci/djs142. [DOI:10.1093/jnci/djs142] [PMID] []
10. Singletary SE. Surgical margins in patients with early-stage breast cancer treated with breast conservation therapy. The American journal of surgery. 2002;184(5):383-93. doi: 10.1016/s0002-9610(02)01012-7. [DOI:10.1016/S0002-9610(02)01012-7] [PMID]
11. Jobsen JJ, Van Der Palen J, Ong F, Meerwaldt JH. Differences in outcome for positive margins in a large cohort of breast cancer patients treated with breast-conserving therapy. Acta oncologica. 2007;46(2):172-80. doi: 10.1080/02841860600891325. [DOI:10.1080/02841860600891325] [PMID]
12. Vrieling C, Collette L, Fourquet A, Hoogenraad W, Horiot J-C, Jager J, et al. Can patient-, treatment-and pathology-related characteristics explain the high local recurrence rate following breast-conserving therapy in young patients? European journal of cancer. 2003;39(7):932-44. doi: 10.1016/s0959-8049(03)00123-0. [DOI:10.1016/S0959-8049(03)00123-0] [PMID]
13. Braunstein LZ, Taghian AG, Niemierko A, Salama L, Capuco A, Bellon JR, et al. Breast-cancer subtype, age, and lymph node status as predictors of local recurrence following breast-conserving therapy. Breast cancer research and treatment. 2017;161(1):173-9. doi: 10.1007/s10549-016-4031-5. [DOI:10.1007/s10549-016-4031-5] [PMID]
14. Lupe K, Truong PT, Alexander C, Lesperance M, Speers C, Tyldesley S. Subsets of women with close or positive margins after breast-conserving surgery with high local recurrence risk despite breast plus boost radiotherapy. International Journal of Radiation Oncology Biology Physics. 2011;81(4):e561-e8. doi: 10.1016/j.ijrobp.2011.02.021. [DOI:10.1016/j.ijrobp.2011.02.021] [PMID]
15. Gabos Z, Thoms J, Ghosh S, Hanson J, Deschênes J, Sabri S, et al. The association between biological subtype and locoregional recurrence in newly diagnosed breast cancer. Breast cancer research and treatment. 2010;124(1):187-94. doi: 10.1007/s10549-010-1135-1. [DOI:10.1007/s10549-010-1135-1] [PMID]
16. Millar EK, Graham PH, O'Toole SA, McNeil CM, Browne L, Morey AL, et al. Prediction of local recurrence, distant metastases, and death after breast-conserving therapy in early-stage invasive breast cancer using a five-biomarker panel. Journal of clinical oncology. 2009;27(28):4701-8. doi: 10.1200/JCO.2008.21.7075. [DOI:10.1200/JCO.2008.21.7075] [PMID]
17. Russo AL, Arvold ND, Niemierko A, Wong N, Wong JS, Bellon JR, et al. Margin status and the risk of local recurrence in patients with early-stage breast cancer treated with breast-conserving therapy. Breast cancer research and treatment. 2013;140(2):353-61. doi: 10.1007/s10549-013-2627-6. [DOI:10.1007/s10549-013-2627-6] [PMID]
18. Merino T, Ip T, Domínguez F, Acevedo F, Medina L, Villaroel A, et al. Risk factors for loco-regional recurrence in breast cancer patients: a retrospective study. Oncotarget. 2018;9(54):30355-62. doi: 10.18632/oncotarget.25735. [DOI:10.18632/oncotarget.25735] [PMID] []
19. Foulkes WD, Smith IE, Reis-Filho JS. Triple-negative breast cancer. New England journal of medicine. 2010;363(20):1938-48. [DOI:10.1056/NEJMra1001389] [PMID]
20. Nguyen PL, Taghian AG, Katz MS, Niemierko A, Abi Raad RF, Boon WL, et al. Breast cancer subtype approximated by estrogen receptor, progesterone receptor, and HER-2 is associated with local and distant recurrence after breast-conserving therapy. Journal of clinical oncology. 2008;26(14):2373-8. doi: 10.1200/JCO.2007.14.4287. [DOI:10.1200/JCO.2007.14.4287] [PMID]
21. Lowery AJ, Kell MR, Glynn RW, Kerin MJ, Sweeney KJ. Locoregional recurrence after breast cancer surgery: a systematic review by receptor phenotype. Breast cancer research and treatment. 2012;133(3):831-41. doi: 10.1007/s10549-011-1891-6. [DOI:10.1007/s10549-011-1891-6] [PMID]
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