Lumpectomy Cavity Shaved Margins Do Not Impact Re-excision Rates in Breast Cancer Patients
Lumpectomy Cavity Shaved Margins Do Not Impact Re-excision Rates in Breast Cancer Patients
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DOI：
10.1245/s10434-011-1909-7
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发表时间：
2011-10-01
影响因子：
3.7
通讯作者：
Specht, Michelle C.
中科院分区：
文献类型：
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作者：
Coopey, Suzanne B.;Buckley, Julliette M.;Specht, Michelle C.
背景在乳房肿瘤切除术时进行腔切缘（SCM）的益处尚不清楚。我们试图确定是否采取SCM通过增加切除的总乳腺组织体积来降低再切除率。我们对2004年至2006年接受乳房肿瘤切除术的乳腺癌患者进行了回顾性分析。患者分为三组。第1组仅行肿块切除术，第2组行肿块切除术加选择性（1-3）SCM，第3组行肿块切除术加完全性（>= 4）SCM。比较两组的病理结果和手术效果。本研究纳入了773例接受肿块切除术治疗的癌症;第1组197例，第2组130例，第3组446例。第1组切除的乳腺组织平均总体积（106.6 cm（3））显著大于第2组（79.3 cm（3））和第3组（76.3 cm（3））切除的体积。两组的再次切除率和保乳治疗（BCT）成功率无显著差异。尽管第2组和第3组切除的乳腺组织总量较低，但在中位随访54个月时，局部复发率（LRR）没有显著增加。在乳房肿瘤切除术期间采取额外的SCM导致切除的乳腺组织的总体体积显著降低，而LRR没有增加。与先前的研究相反，我们发现SCM并没有降低再切除率或影响BCT的成功。因此，采用SCM的主要优点似乎是切除的乳房组织较少，这可能会改善美容效果。
Background. The benefits of taking shaved cavity margins (SCM) at the time of lumpectomy are unclear. We sought to determine if taking SCM decreases re-excision rates by increasing the total breast tissue volume excised.Methods. We undertook a retrospective review of breast cancer patients who underwent lumpectomy from 2004 to 2006. Patients were divided into three groups. Group 1 had lumpectomy alone, group 2 had lumpectomy plus select (1-3) SCM, and group 3 had lumpectomy plus complete (>= 4) SCM. Pathologic findings and surgical outcomes were compared between groups.Results. 773 cancers treated by lumpectomy were included in this study; 197 were in group 1, 130 were in group 2, and 446 were in group 3. The mean total volume of breast tissue excised in group 1 (106.6 cm(3)) was significantly larger than the volume excised in groups 2 (79.3 cm(3)) and 3 (76.3 cm(3)). Rates of re-excision and successful breast-conservation therapy (BCT) were not significantly different between groups. Despite a lower total volume of breast tissue excised in groups 2 and 3, there was no significant increase in locoregional recurrence rates (LRR) at median follow-up of 54 months.Conclusions. Taking additional SCM during lumpectomy resulted in a significantly lower overall volume of breast tissue excised, with no increase in LRR. Contrary to prior studies, we found that SCM did not decrease re-excision rates or impact the success of BCT. Therefore, the main advantage of taking SCM appears to be that less breast tissue is excised, which could potentially improve cosmetic outcomes.