Abstract
Breast conserving surgery combined with sentinel node biopsy represents currently the gold standard of treatment for early breast cancer. Although breast conserving surgery has been a widely accepted method for many years, there remain some highly controversial unresolved issues. The present analysis focused on the resection margin as one of the key factors for local control of the disease. Patient disease free survival and overall survival were collected from patients undergoing breast conserving surgery from 2004 to 2009 at the Department of Surgery Atlas hospital Zlin, Czech Republic. All patients with resection margin less then 5 mm were re-resected to achieve this clear resection margin of 5mm or more. Disease free survival (more specifically local relapse free survival, metastasis free survival and regional free survival) and overall survival were assessed. The data on 330 patients were analyzed and 286/330 cases had complete follow-up. After a median follow-up of 70 months, 7 patients with isolated local relapse were identified (2.44%), 13 patients with distant metastasis without local relapse (4.54%) and 2 patients with relapse in the axilla without local relapse in the breast (0.7%). The final decision about the extent of resection margin remains controversial but based on the data on local control presented here it seems reasonable to increase the criteria for a clear resection margin to 5 mm.
Highlights
Breast conserving surgery combined with sentinel node biopsy represents currently the gold standard of treatment for early breast cancer
It should be kept in mind that the final therapeutic outcome is the result of multidisciplinary collaboration between the specialists involved and even if the surgeon performs outstanding surgery, satisfactory outcome will not be achieved if radiotherapy or systemic adjuvant treatment are suboptimal, or vice versa[7]. The aim of this retrospective study was to investigate whether the 5mm free resection margin has any impact on local relapse rate by comparing our data with that published on resection margin and local relapse rate
After analysis of 533 stage I and stage II breast cancer patients with close margins or negative margins and 7% local relapse rate at 8 years, Park et al concluded that pathological margin status together with adjuvant therapy are the major predictors of local relapse[8]
Summary
Breast conserving surgery combined with sentinel node biopsy represents currently the gold standard of treatment for early breast cancer. Breast conserving surgery has been a widely accepted method for many years, there remain some highly controversial unresolved issues. The present analysis focused on the resection margin as one of the key factors for local control of the disease. Patient disease free survival and overall survival were collected from patients undergoing breast conserving surgery from 2004 to 2009 at the Department of Surgery Atlas hospital Zlin, Czech Republic. Disease free survival ( local relapse free survival, metastasis free survival and regional free survival) and overall survival were assessed. The final decision about the extent of resection margin remains controversial but based on the data on local control presented here it seems reasonable to increase the criteria for a clear resection margin to 5 mm.
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