Accuracy of Intraoperative Gross Examination of Surgical Margin Status in Women Undergoing Partial Mastectomy for Breast Malignancy

Balch, Glen C.; Mithani, Suhail K.; Simpson, Jean F.; Kelley, Mark C.
January 2005
American Surgeon;Jan2005, Vol. 71 Issue 1, p22
Academic Journal
Margin status is an important prognostic factor for local recurrence after partial mastectomy for breast malignancy. Options for intraoperative evaluation of margin status include gross examination of the specimen, frozen section, and "touch preparation" cytology. This study evaluates the accuracy of gross examination without other intraoperative pathological analysis as a method of determining margin status. Records of 254 consecutive patients undergoing partial mastectomy for 255 breast malignancies (199 invasive, 56 DCIS) over 6 years were analyzed retrospectively. All women underwent en bloc excision of the primary lesion with gross examination of margin status by the surgeon and pathologist. All suspicious areas were reexcised, and the specimen was inked, serially sectioned at 2-3 mm intervals and examined with hematoxylin and eosin (H&E) stains. Specimens with tumor <2 mm from a margin were considered margin-positive and those with all tumor ≥2 mm from the margin were designated margin-negative. One hundred fourteen (45%) of the 255 segmental resections were considered to have grossly tumor-free margins, and intraoperative reexcision was not performed. Ninety-six (84%) of these specimens had histologically negative margins. Gross examination prompted intraoperative reexcision in 141 (55%) cases. Ninety-five (67%) of these 141 resections had tumor-free margins on histopathology. Overall, the final margin was involved in 64 of the 255 partial mastectomies. Seventeen (27%) women with initially margin-positive resections underwent mastectomy, while 46 (72%) underwent reexcision, which was margin-negative in 41 (89%). After a median follow-up of 42 months, there have been eight (3.5%) local recurrences. The initial margin-positive rate was similar in ductal carcinoma in situ (DCIS) (30%) and invasive carcinoma (24%). Margin status was correlated with nodal status; there was no correlation with age, tumor size, grade hormone receptor status, or type o...


Related Articles

  • Skip Lesion of DIN (DCIS) in the Nipple in a Case of Breast Cancer. Tramm, Trine; Zuckerman, Kaye; Tavassoli, Fattaneh A. // International Journal of Surgical Pathology;Dec2011, Vol. 19 Issue 6, p817 

    The authors present a case of breast cancer with a skip lesion of DIN 1 (ductal carcinoma in situ [DCIS] grade 1) in the nipple, leaving the base of the nipple free of disease. During the surgical procedure of nipple-sparing mastectomy (NSM) a frozen section evaluation of the base of the nipple...

  • Accelerated Hypofractionated Radiotherapy Schedules in Breast Cancer: A Review of the Current Literature. Kalogeridi, Maria Aggeliki; Kelekis, Nikolaos; Kouvaris, John; Platoni, Kalliopi; Kyrias, George; Pectasides, Demitrios; Kouloulias, Vassilis // Reviews on Recent Clinical Trials;Sep2009, Vol. 4 Issue 3, p147 

    Lumpectomy followed by breast irradiation is an alternative to mastectomy for patients with early-stage breast cancer. The purpose of radiation treatment following lumpectomy is to minimize the risk of recurrent cancer in the treated breast with as little toxicity as possible so that good...

  • Octogenarians: Noncompliance with Breast Cancer Treatment Recommendations. STRADER, LINDSAY A.; HELMER, STEPHEN D.; YATES, CHRISTINE L.; TENOFSKY, PATTY L. // American Surgeon;Nov2014, Vol. 80 Issue 11, p1119 

    Recent research suggests that women older than 70 years of age with early breast cancer who choose lumpectomy may forgo radiation if they take antihormonal medication. However, many elderly patients choose to forgo both radiation and hormonal therapy. This study assessed treatment compliance in...

  • Treatment -- Surgery. Burchell, Joy; Chaudary, Murid; Miles, David; Vinh-Hung, Vincent // Current Medical Literature: Breast Cancer;2011, Vol. 23 Issue 3, p108 

    The article discusses a research study which compared skin-sparing mastectomy (SSM) with conventional mastectomy (CM) in terms of rate of recurrence. It references a study by M. Yi et al, published in a 2011 issue of the journal "Cancer." Findings showed recurrence rate of 5.3% on patients who...

  • Aussie sisters tell: We had our breasts removed TO SAVE OUR LIVES. Hayne, Julie // Woman's Day (Australia Edition);9/14/2009, Vol. 61 Issue 37, p40 

    The article reports on Gold Coast sisters Veronica and Elisha Neave and Christine Keepence who were all diagnosed with BRCA2, an inherited gene disorder which increases the risk of developing breast cancer. After doing a lot of research, and considering our family history of breast cancer,...

  • Unwelcome Guest. O'Connor, Sarah H. // Commonweal;5/20/2005, Vol. 132 Issue 10, p31 

    Presents an article on breast cancer and its impact on the life of the diagnosed patient. Changes in the behavior of a friend when she was diagnosed with breast cancer; Visit to a Mennonite mother who had mastectomy while volunteering in a hospital; Views on the philosophy Memento mori, which...

  • Is a 0.2% chance of death from breast cancer worth a bilateral prophylactic mastectomy?  // Contemporary OB/GYN;Jun2005, Vol. 50 Issue 6, p15 

    Reports on the chance of death for women with breast cancer who undergone bilateral prophylactic mastectomy, according to a retrospective case-cohort study of women in the U.S. in June 2005. Information on the risk factors of the breast cancer; Ratio for breast cancer occurrence after bilateral...

  • Are surgeons discussing breast reconstruction with Ca patients? Hillard, Paula J. // Contemporary OB/GYN;Apr2008, Vol. 53 Issue 4, p21 

    The article discusses research being done on breast reconstruction and cancer. It references a study by A. K. Alderman et al published in a 2008 issue of "Cancer." The study surveyed women with breast cancer in the U.S. wherein they were asked whether they consulted with their general surgeons...

  • Necrotic Complications after Nipple- and Areola-Sparing Mastectomy. Komorowski, Andrzej L.; Zanini, Vittorio; Regolo, Lea; Carolei, Adriana; Wysocki, Wojciech M.; Costa, Alberto // World Journal of Surgery;Aug2006, Vol. 30 Issue 8, p1410 

    Objective: The objective was to analyze the frequency and factors influencing necrotic complication in female patients undergoing nipple- and areola-sparing mastectomy. Summary and background data: Nipple- and areola-sparing mastectomy has recently been shown to yield satisfactory results in a...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics