PROFILE OF PATIENTS SUBMITTED TO RE-EXCISION BY POSITIVE MARGINS IN BREAST CONSERVATIVE SURGERY FOR CANCER TREATMENT – SERIES OF CASES AND ASSOCIATED RISK FACTORS
Nicoli Serquiz de Azevedo, Fernanda Madrassi Campora, Natalie Rios Almeida, Tamara Pinto de Almeida Araújo, Geisilene Russano de Paiva Silva, Julia Yoriko Shinzato, Cesar Cabello dos Santos, Cassio Cardoso-Filho
PROFILE OF PATIENTS SUBMITTED TO RE-EXCISION BY POSITIVE MARGINS IN BREAST CONSERVATIVE SURGERY FOR CANCER TREATMENT – SERIES OF CASES AND ASSOCIATED RISK FACTORS
Nicoli Serquiz de Azevedo, Fernanda Madrassi Campora, Natalie Rios Almeida, Tamara Pinto de Almeida Araújo, Geisilene Russano de Paiva Silva, Julia Yoriko Shinzato, Cesar Cabello dos Santos, Cassio Cardoso-Filho
Institution: CAISM/UNICAMP
Objectives: The ideal margin in breast conservative surgery (BCS) is still controversial and the re-excision is common, which can result in delayed adjuvant treatment, higher morbidity and poor cosmetic outcome. Clinical characteristics and anatomic-pathological conditions of patients requiring re-excision after BCS were described. Methods: There were included 49 women with breast cancer in follow-up of a single academic institution, from January 2009 to December 2010, clinical stages 0, I and II who were admitted for re-excision after BCS, and medical records and pathological reports were retrospectively reviewed. Results: The mean age was 54 years, 65% were in post-menopausal status, 53% presented a body mass index higher than 25, and 45% of the cases were stage 0. The rate of re-excision was 9.37%, 31% of the surgeries were indicated by narrowed margins, and in 61% of cases there were no residual neoplasic disease in surgical specimens of the re-excision. The average time between the first approach and the re-excision was 90 days. Regarding residual disease, there was no statistically significant difference in the analysis of the subgroups in relation to clinical characteristics and/or anatomic-pathological features. Conclusion: The rates of pathological findings without residual disease show that surgical indications may be revised and individualized. If the initial surgical margins are markedly positive, re-excision is definitely indicated. If the resection margins are free, there is no evidence that greater benefit would be obtained from a broader re-excision. There was a trend of new surgical procedure indication if the initial BMI was higher. It is necessary to reflect the importance of ensuring the negative margins, as well as the indication of a new surgical approach.