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January 1989

Implications of Accurate Pathologic Margins in the Treatment of Primary Breast Cancer

Author Affiliations

From the Department of Surgery, Bryn Mawr Hospital, Pa (Drs Frazier and Rose), and the Department of Surgery, Thomas Jefferson University, Philadelphia (Drs Frazier, Wong, and Rose). Dr Wong is now with the Department of Surgery, University of Arizona, Tucson.

Arch Surg. 1989;124(1):37-38. doi:10.1001/archsurg.1989.01410010043009

• Eighty-seven patients who underwent mastectomy or reexcision following a previous segmental resection with pathologic margins evaluated at that time were restudied following their definitive therapy. Of these, 40 (46.0%) had involved margins, 28 (32.2%) had close margins, and 19 (21.8%) had clear margins. Residual tumor was subsequently found in 21 (52.5%) of 40, nine (32.1%) of 28, and five (26.3%) of 19, respectively. Analysis of specimens for quadrant of residual tumor showed 27 (31.0%) of 87 patients in the same quadrant, and 11(14.7%) of 75 present in a different quadrant. The assessment of microscopic margins may be misleading since 29.8% (14/47) of patients with clear or close margins subsequently had residual tumor, and 47.5% (19/40) of those with involved margins had no residual tumor found. Further studies are essential to define the optimum guidelines for tumor excision at the time of segmental resection.

(Arch Surg 1989;124:37-38)

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