Positive Tumor Margins in Wide Local Excision of Breast Cancer: A 10-Year Retrospective Study

Abstract

Background. The safety of wide local excision as a standard surgical option for early stage breast cancer management in Ghana has not been evaluated. The aim of this study was to use retrospective histopathological descriptive study to evaluate the prevalence of positive tumor margins in wide local excision specimens and offer recommendations. Study design. We reviewed 147 breast lumps, following wide local excision, which were received in the Department of Pathology, for positive tumor margins. The data was analyzed using SPSS software (version 16). Results. A total of 2,751 female breast cancers were diagnosed during the study period, of which 147 (5.3%) were from wide local excisions (lumpectomies). Thirty-one (21.0%) had positive tumor margins. The mean age of women with positive margins was 53.4 (SD = 17.1) years. The mean size of primary tumor was 4.0 (SD = 2.1) cm, the majority (53.0%) of which were greater than 2.0 cm, but less than or equal to 5.0 cm (T2). A total of 26 (83.4%) of these tumors were invasive ductal carcinomas (NOS), 24 (92.3%) of the cases had combined Bloom-Richardson grading, and many, 10 (41.7%), were grade 1. Conclusion. Our study shows that 21.0% of all wide local excision biopsies had positive tumor margins, a figure that is comparable to those of other studies. Tumors with positive margins in this study were large, 4.0 cm (T2), and common in relatively young women. Treatment failure is therefore likely to occur in these patients.