Local recurrence of breast cancer after breast conservation therapy in patients examined by means of stereotactic core-needle biopsy.

Abstract

To evaluate the incidence of locally recurrent breast cancer in patients treated with breast conservation surgery and radiation therapy to determine if increased local recurrence is observed in women examined by means of stereotactic core-needle biopsy (SCNB). Records of 551 consecutive patients with breast cancer who were treated with conservation surgery and radiation therapy were reviewed retrospectively. The 551 cases were divided into three groups: those examined by means of SCNB (n = 86), those examined by means of excisional biopsy preceded by needle localization (n = 242), and those in which the masses were palpable and who underwent biopsy without imaging guidance (n = 223). The local recurrence rate and the Mantel-Haenszel statistic for survival curves were calculated for each group. To test for statistical significance, chi(2) analysis was performed for categorical variables and a t test or analysis of variance was performed for calculation of continuous variables. With a mean follow-up of 4.9 years (range, 2.0-8.9 years), tumor recurrence rate in the SCNB group was 2.3% (two of 86), resulting in a 5-year actuarial recurrence-free rate of 0.96 +/- 0.03. For the needle-localized biopsy group, recurrence rate was 5.4% (13 of 242), with a 5-year actuarial tumor recurrence-free rate of 0.88 +/- 0.03. For the non-image-guided biopsy group, the recurrence rate was 10.3% (23 of 223), with a 5-year actuarial recurrence-free rate of 0.84 +/- 0.03. These rates were not significantly different when the SCNB group was compared with the needle-localized biopsy group. However, the recurrence-free rate was significantly greater for the SCNB group than that for the non-image-guided biopsy group (P =.03). In the present series to date, cancers diagnosed by means of SCNB were not associated with an increased incidence of local recurrence after breast conservation surgery and radiation therapy.