Safe selection criteria for breast conservation without radical excision in primary operable invasive breast cancer

In a previous series from this unit of 263 women with primary operable breast cancer treated by macroscopic lumpectomy and breast irradiation, local recurrence was high. An audit at a median follow up of 36 months showed 56 (21%) ipsilateral breast recurrences. Eighteen of these recurrences were agg...

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Bibliographic Details
Published in:European journal of cancer (1990) 1995-12, Vol.31 (13), p.2191-2195
Main Authors: Sibbering, D.M., Galea, M.H., Morgan, D.A.L., Elston, C.W., Ellis, I.O., Robertson, J.F.R., Blamey, R.W.
Format: Article
Language:English
Subjects:
Adult
Aged
breast cancer
breast conservation
Breast Neoplasms - surgery
Clinical Protocols
Female
Humans
local recurrence
Mastectomy, Segmental
Medical Audit
Middle Aged
Neoplasm Recurrence, Local - epidemiology
Neoplasm Recurrence, Local - prevention & control
Patient Selection
Prospective Studies
treatment
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Summary:In a previous series from this unit of 263 women with primary operable breast cancer treated by macroscopic lumpectomy and breast irradiation, local recurrence was high. An audit at a median follow up of 36 months showed 56 (21%) ipsilateral breast recurrences. Eighteen of these recurrences were aggressive and uncontrolled. Multivariate analysis shows patient age, lymphovascular invasion, tumour size and nodal status to be predictive of local recurrence (Locker AP, et al., Br J Surgery 1989, 76, 890–894). New selection criteria for breast conservation were defined based on these data and also on securing an adequate clear margin of excision. In a subsequent prospective series of 275 women fulfilling these criteria, 6 women (2.2%) developed ipsilateral breast recurrence at the same median follow up of 36 months. In none was this uncontrolled and aggressive. Breast conservation, without radical excision, is safe as long as the selection criteria described are followed.
ISSN:0959-8049
1879-0852
DOI:10.1016/0959-8049(95)00455-6