HISTOPATHOLOGICAL STUDY OF LOCAL RESIDUAL CARCINOMA AFTER SIMULATED LUMPECTOMY

From 1989 to 1991, 24 patients with invasive ductal carcinoma underwen t simulated lumpectomy at Tokyo Women's Medical College Daini Hospital . The mastectomy specimens were then examined histopathologically in s erial sections for the presence of residual tumors or multicentricity. Lumpectomy specimens from cancer foci al resected margins were also e xamined. In this study, 23 of 24 patients demonstrated positive resect ion margins (95.8%). Residual tumors were found in mastectomy specimen s from 16 patients (66.7%); unilateral multifocal carcinomas were foun d in 2 of these patients (8.3%), The incidence and severity of residua l tumors did not correlate with primary tumor size or the distance bet ween the nipple and the primary tumor but directly correlated with the severity of intraductal spread of the primary tumor. Tumors with cent ral necrosis were associated with a higher incidence of residual tumor s. Our study thus indicates that there is a high risk that some residu al tumor will be left in the conserved breast when lumpectomy is perfo rmed. Multifocal carcinoma and tumors showing severe intraductal sprea d and central necrosis are thus associated with extensive residual tum ors and are likely to cause local recurrence.