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J Cancer Res Clin Oncol. 2014 Apr;140(4):599-605. doi: 10.1007/s00432-014-1597-3. Epub 2014 Feb 9.

Impact of atypical hyperplasia at margins of breast-conserving surgery on the recurrence of breast cancer.

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1
Breast Tumor Center, Sun Yat-Sen Memorial Hospital, 33 Yingfeng Road, Guangzhou, 510288, China.

Abstract

PURPOSE:

Atypical hyperplasia (AH) is associated with a relatively higher risk of subsequent development of cancer. It remains controversial whether it is necessary to re-excise AH found at surgical margins during breast-conserving surgery (BCS). The aim of this study was to determine the impact of atypical ductal/lobular hyperplasia found at the margins during BCS on the prognosis of early-stage breast cancer patients.

METHODS:

A retrospective analysis comparing patients with AH and receiving no further surgical treatment (n = 233) to those without AH at the margins during BCS (n = 158) was performed.

RESULTS:

At a median follow-up of 76 months, the 5- and 8-year rates of ipsilateral breast tumor recurrence (IBTR) were 3.26 and 8.79% for women with AH and 2.56 and 8.95% for women without AH, respectively. There were no significant differences between the two groups in terms of IBTR (p = 0.803), distant-metastasis-free survival (DMFS) (p = 0.749), or overall survival (OS) (p = 0.165). Moreover, no significant differences were found in IBTR, DMFS, or OS between patients with severe atypical hyperplasia (n = 86) and those without AH (n = 158) (p = 0.81, 0.82, and 0.78, respectively). Additionally, young women or those with ductal carcinoma in situ or triple-negative breast cancer with AH involving margins did not have a higher IBTR rate when compared to similar patients without AH.

CONCLUSIONS:

This study suggests that AH found at the margins during BCS does not increase the risk of subsequently developing an IBTR. There is not enough evidence for re-excision of AH found at the margins during BCS in patients with early-stage breast cancer.

PMID:
24509653
DOI:
10.1007/s00432-014-1597-3
[Indexed for MEDLINE]
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