Breast-conserving surgery: adjuvant therapy safe for close anterior margins

  • Boundouki G & al.
  • Breast Cancer Res Treat
  • 22 Apr 2019

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • 5- and 10-year recurrence rates are no different for nonsurgical vs surgical management of close anterior margins after breast conserving surgery (BCS) for invasive or in situ breast cancer.

Why this matters

  • No current guidelines shed light on whether nonsurgical management of close anterior margins is safe.
  • This study suggests that nonsurgical management of close anterior margins is likely to be safe over the long-term when combined with appropriate adjuvant therapy.

Study design

  • Retrospective cohort of 6922 patients who underwent BCS for breast cancer at 2 UK hospitals from 2000 to 2008.
  • Close anterior margins (≤2 mm) after BCS were identified in 277 of these patients, of whom 220 underwent re-excision surgery and 57 were managed nonsurgically.
  • Funding: None disclosed.

Key results

  • Overall, 7% of the nonsurgical group had local recurrence of breast cancer and 5.45% of the surgical group had local recurrence.
  • No differences between groups in type of adjuvant therapy after BCS (endocrine therapy, radiotherapy, chemotherapy, and trastuzumab).
  • No differences between groups in 5-year recurrence-free survival (RFS: 98.2%; 95% CI, 87.8%-99.7%) and 10-year RFS (92.2%; 95% CI, 80.3%-97.0%; overall HR, 1.24; P=.71).

Limitations

  • Observational, retrospective design.

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