Breast Cancer

Abstract

• The extent of excision performed for mammary carcinoma prior to radiotherapy as a risk factor for local recurrence was studied in 503 patients. Three hundred twenty-three tumors (62%) were excised with a minimal rim of tissue (tumorectomy). One hundred forty-two patients (27%) had wide excision and 56 (11%) had quadrantectomy. Tumor stage, size, and radiation treatment were similar for all groups. Forty-one percent of tumorectomies had involved margins, and only 14% and 7% were involved in the wide excision and quadrantectomy groups, respectively. Local failure was 15% for tumorectomy, 7% for wide excision, and 5% for quadrantectomy. In T1 ductal carcinoma, only 4% of those with excisions greater than 5 cm had recurrences. Lesser excision had 20% recurrence. Extent of excision before radiotherapy is an important risk factor for recurrence. Failure was inversely proportional to the amount of breast tissue resected. Narrow excision should be discouraged since a larger tumor burden remains that may not be sterilized by radiation. (Arch Surg. 1992;127:411-415)