RISS 검색 - 국내학술지논문 상세보기

다국어 초록 (Multilingual Abstract)

Purpose: Re-excisions after breast-conserving surgery (BCS) for breast cancer cause delays in the adjuvant treatment, increased morbidity, and leads to poor aesthetic results. Thus, efforts to reduce the re-excision rate are essential. This study aimed to conclusively determine the re-excision rate and the factors associated with re-excision after BCS. Methods: We retrospectively reviewed the medical records and pathological reports of 711 cases that underwent BCS for early-stage breast cancer. Univariate and multivariate analyses were performed. Results: Of the 711 cases of BCS, 71 (10.0%) required re-excision. Patients in the re-excision group were younger than those in the no re-excision group. Non-palpable lesions, the presence of non-mass-like enhancement at magnetic resonance imaging, multifocality, the presence of a ductal carcinoma in situ (DCIS) component, and an infiltrative tumor border were also significantly associated with re-excision. Multivariate analysis indicated that younger age, non-palpable lesions, multifocal lesions, and the presence of a DCIS component were factors which were independently associated with re-excision. Tumors located in the lower inner quadrant had a relatively high involved resection margin rate as well as a narrow resection margin width, especially at the superior and medial margins. Lateral margins showed a tendency toward a wider resection margin width. Conclusion: At our institution, the rate of re-excision was low despite the lack of an intraoperative frozen section. Patients with non-palpable or multifocal tumors, a DCIS component, or those who were younger than 50 years were more likely to require re-excision after BCS. These factors should be considered when planning surgical management of early-stage breast cancer. Positive resection margin rates and margin widths differed on a directional basis based on tumor location, and these differences were considerable.

참고문헌 (Reference)

1 김성원, "신생병원의 5년 유방암 치료 경험: 임상 데이터 웨어하우스를 이용한 분석" 한국유방암학회 13 (13): 96-103, 2010

2 Fisher B, "Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer" 347 : 1233-1241, 2002

3 Veronesi U, "Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer" 347 : 1227-1232, 2002

4 Coopey S, "The safety of multiple re-excisions after lumpectomy for breast cancer" 18 : 3797-3801, 2011

5 Aziz D, "The role of reexcision for positive margins in optimizing local disease control after breast-conserving surgery for cancer" 12 : 331-337, 2006

6 Lovrics PJ, "The relationship between surgical factors and margin status after breast-conservation surgery for early stage breast cancer" 197 : 740-746, 2009

7 O’Sullivan MJ, "The effect of multiple reexcisions on the risk of local recurrence after breast conserving surgery" 14 : 3133-3140, 2007

8 Kuhl C., "The current status of breast MR imaging. Part I. Choice of technique, image interpretation, diagnostic accuracy, and transfer to clinical practice" 244 : 356-378, 2007

9 Lovrics PJ, "Technical factors, surgeon case volume and positive margin rates after breast conservation surgery for early-stage breast cancer" 53 : 305-312, 2010

10 Singletary SE, "Surgical margins in patients with early-stage breast cancer treated with breast conservation therapy" 184 : 383-393, 2002