SURGICAL MARGINS AFTER NEEDLE-LOCALIZATION BREAST BIOPSY

BACKGROUND: The use of needle-localization breast biopsy (NLBB) for th e early diagnosis of breast cancer is common. The therapeutic adequacy of tumor-free margins following NLBB is unknown. We hypothesized that the presence of residual tumor after reexcision (mastectomy, tylectom y, or quadrantectomy) does not depend on the margin status following N LBB. PATIENTS AND METHODS: Retrospective cohort analysis was performed on 890 consecutive NLBBs executed between January 1990 and June 1994. Patients with invasive breast neoplasia were divided into two groups based on the tumor margins after NLBB. Group 1 were the women with pos itive margins, and group 2 had negative margins. Breast specimens afte r reexcision were reviewed for evidence of residual invasive carcinoma . RESULTS: Invasive neoplasia was present in 107 patients (12%). Surgi cal margins and definitive records of care were available for 96 of th em (90%). All 45 patients in group 1 and 38 (75%) of 51 patients in gr oup 2 underwent reexcision of the initial biopsy site (P = 0.36). Resi dual invasive carcinoma was present in 10 patients (22%) in group 1 an d 3 (8%) in group 2 (P = 0.13). CONCLUSION: Invasive breast neoplasia diagnosed by NLBB requires reexcision regardless of tumor margins to a chieve complete local surgical eradication of tumor.