INCIDENCE OF GROSS AND MICROSCOPIC CARCINOMA IN SPECIMENS FROM PATIENTS WITH BREAST-CANCER AFTER RE-EXCISION LUMPECTOMY

Objective: The aims of this study were to quantify the amount of the r esidual carcinoma in re-excision lumpectomy specimens and retrospectiv ely analyze the relationship between clinical parameters and the chara cteristics of the primary excision to these quantities of the residual tumor. Summary Background Data: Because complete gross surgical excis ion of the primary tumor is important in minimizing local recurrence i n women undergoing breast conservation therapy, re-excision of the ini tial biopsy site is commonly practiced when the initial primary tumor excision shows inadequate or undeterminable margins. Several studies h ave reported a significant proportion of re-excision specimens to cont ain residual tumor (32% to 63%), but to the authors' knowledge, none h ave quantified the amount of residual tumor. Methods: The authors revi ewed 192 re-excisions retrospectively to quantify the amount of residu al carcinoma and correlate the quantities with the characteristics of the primary tumor resection. Results: No tumor was found in 105 (54.7% ) specimens, 46 (23.9%) had minimal microscopic disease, 23 (12.0%) ha d extensive microscopic disease, and 18 (9.4%) had gross residual canc er. Characteristics significantly associated with the quantity of resi dual disease included clinical tumor stage (T stage), pathologic T sta ge, and the margin status of the primary excision. The majority (62.1% ) of re-excision specimens containing residual carcinoma had an invasi ve component. Conclusions: It was concluded that re-excision lumpectom y yields an important number of patients with residual carcinoma and t hat characteristics of both the primary tumor and primary excision sig nificantly predict the quantity of residual cancer in the specimen. In addition, these results support the policy of performing re-excision for patients with inadequate or undeterminable margins for the primary excision.