Surgical margins factors determining the extent of tumor resection in breast cancer patients treated by conservative surgery

ABSTRACT

A total of 102 female patients proven to have breast carcinoma was treated by modified radical mastectomy. Risk factors of local recurrence [tumor size, histological type and grade, presence of extensive intraductal component [EIC], vascular invasion and lymph node status] in addition to resection margins were examined. Immunohistochemical expression of adhesion molecule CD44 and prognostic marker C-erb B-2 were evaluated and correlated to the extent of tumor spread beyond the primary site. Tumor bed biopsies from the modified radical mastectomy specimens were taken at distances from 1-6 cm at six positions [anterior, posterior, lateral, medial, upper and lower] and examined for tumor extension. Risk factors of local recurrence in breast carcinoma [histological type, grade, EIC and lymph node status], in addition to adhesion molecule CD44 and prognostic marker C-erb B-2 should be considered in the selection of patients for conservative lumpectomy treatment and in determining the extent of surgical resection. A safety margin of 3 cm is considered to be sufficient in cases of invasive duct carcinoma without intraductal component