Introduction
Breast-conserving surgery (BCS) is a widely accepted treatment for early-stage breast cancer, offering oncological safety alongside improved cosmetic outcomes. Achieving negative surgical margins is critical in minimizing the risk of local recurrence. This study evaluates the correlation between surgical margin status and recurrence rates over a five-year follow-up period.
Methods
A prospective study was conducted involving 150 female patients with stage I or II breast cancer who underwent BCS at a tertiary care center. Surgical margins were classified as negative (no tumor within 1 mm), close (tumor within 1 mm), or positive (tumor at inked margin). Preoperative clinical and pathological data, including tumor size, grade, lymph node status, and receptor profile, were collected. Patients received appropriate adjuvant therapy. Follow-up was scheduled every six months for the first three years, then annually. Local recurrence was confirmed via imaging and histopathology. Statistical analysis was performed using logistic regression and Kaplan-Meier survival curves (p < 0.05 considered significant).
Results
The overall local recurrence rate was 8%. Recurrence rates were highest among patients with positive margins (25%), followed by close (10%) and negative margins (5%) (p<0.05). Tumor size >2 cm, high grade, lymph node positivity, and HER2-positive status were significantly associated with recurrence. Kaplan-Meier analysis indicated reduced recurrence-free survival in patients with positive margins. Combined chemotherapy and radiation reduced recurrence in higherrisk groups.
Conclusion
Clear surgical margins significantly reduce local recurrence in BCS. Tumor biology and adjuvant therapy also play essential roles in optimizing outcomes. A multidisciplinary approach is crucial to improving long-term care.
Authors
Rakshana Munusamy
King’s College Hospital NHS Foundation Trust, London, United Kingdom
Naveen Bose J
Royal Free London NHS Foundation Trust, London, United Kingdom