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Geburtshilfe Frauenheilkd 2012; 72(11): 1018-1023
DOI: 10.1055/s-0032-1327980
Original Article
GebFra Science
Georg Thieme Verlag KG Stuttgart · New York

Re-excision Rates and Local Recurrence in Breast Cancer Patients Undergoing Breast Conserving Therapy

Reexzisions- und Lokalrezidivrate bei Brustkrebspatientinnen nach brusterhaltender Operation
M. Dieterich
1   Universitätsfrauenklinik und Poliklinik, University of Rostock, Rostock
,
H. Dieterich
2   Breast Center Rheinfelden, Rheinfelden
,
H. Moch
3   Institute of Clinical Pathology, University of Zurich, Zurich, Switzerland
,
C. Rosso
2   Breast Center Rheinfelden, Rheinfelden
3   Institute of Clinical Pathology, University of Zurich, Zurich, Switzerland
› Author Affiliations
Further Information

Publication History

received 19 July 2012
revised 28 October 2012

accepted 28 October 2012

Publication Date:
12 December 2012 (online)

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Abstract

Background: Controversy continues over the impact of re-excision (RE) on local recurrence (LR) in patients with invasive breast cancer. Patients and Methods: We investigated factors which could effect RE rates in patients undergoing breast-conserving or oncoplastic surgery. Between 2000 and 2003, 489 patients with stage pT1-pT2 or pN0/1 tumors were evaluated. 74 patients fulfilled the inclusion criteria. Patients were categorized into 3 groups: no RE (n = 25), RE during primary surgery (n = 28), and RE performed during secondary or even tertiary procedure (n = 21). All tumor slides were re-evaluated by a pathologist specializing in breast cancer. Results: Mean follow-up was 70 months with an overall LR rate of 4.1 %. Binary logistic regression revealed no tumor-specific risk factors for RE. There was no LR in the group of patients who did not have RE. There was one case of LR in the group of patients who had RE during primary surgery. Two cases of LR were observed in the group of patients who had two or more surgical procedures. Conclusion: New risk factors for increased RE rates were not observed, reflecting the inconsistent data on risk factors for RE. However, breast cancers should be excised in a single procedure and oncoplastic procedures should be considered.

Zusammenfassung

Hintergrund: Der Einfluss von Reexzisionen (RE) auf die Lokalrezidivate (LR) bei Brustkrebspatientinnen wird nach wie vor kontrovers diskutiert. Patienten und Methoden: Diese Studie untersucht Einflussfaktoren auf die RE-Rate bei Brustkrebspatientinnen nach brusterhaltender oder onkoplastischer Operation. Zwischen 2000 und 2003 wurden 489 Patientinnen mit pT1-pT2- und pN0/1-Tumoren ausgewertet. 74 Patientinnen erfüllten die Einschlusskriterien und wurden in 3 Gruppen unterteilt: keine RE (n = 25), RE während der Primäroperation und RE in einer sekundären Operation (n = 21). Alle Tumorblöcke wurden durch einen auf Brustkrebs spezialisierten Pathologen reevaluiert. Ergebnisse: Der durchschnittliche Beobachtungszeitraum, mit einer LR-Rate von 4,1 %, betrug 70 Monate. Binäre logistische Regressionsanalyse ergab keine tumorspezifischen Risikofaktoren für eine RE. Kein Rezidiv trat in der Gruppe ohne RE auf. In der Gruppe mit RE während der Primäroperation trat ein LR, und in der Gruppe mit RE in einer sekundären oder weiteren Operation traten 2 LR auf. Zusammenfassung: Neue Risikofaktoren für eine erhöhte RE-Rate konnten nicht gefunden werden und spiegeln die inkonsistente Datenlage wider. Brustkrebs sollte des ungeachtet in einer Operation entfernt werden, wobei onkoplastische Techniken berücksichtigt werden müssen.

Key words

oncoplastic surgery - local recurrence - breast-conserving therapy - margin status - re-excision - breast cancer

Schlüsselwörter

onkoplastische Operation - Lokalrezidiv - brusterhaltende Operation - Tumorrand - Reexzision - Brustkrebs
 

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