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논문 기본 정보

자료유형
학술저널
저자정보
Jun Ho Lee (Department of Surgery Samsung Changwon Hospital Sungkyunkwan University School of Medicine) Ha Woo Yi (Division of Breast and Endocrine Surgery Department of Surgery Samsung Medical Center Sungkyunkwan) Soo Youn Bae (Division of Breast and Endocrine Surgery Department of Surgery Samsung Medical Center Sungkyunkwan) Se Kyung Lee (Division of Breast and Endocrine Surgery Department of Surgery Samsung Medical Center Sungkyunkwan) Won Ho Kil (Division of Breast and Endocrine Surgery Department of Surgery Samsung Medical Center Sungkyunkwan) Seok Won Kim (Division of Breast and Endocrine Surgery Department of Surgery Samsung Medical Center Sungkyunkwan) Seok Jin Nam (Division of Breast and Endocrine Surgery Department of Surgery Samsung Medical Center Sungkyunkwan) Jeong Eon Lee (Division of Breast and Endocrine Surgery Department of Surgery Samsung Medical Center Sungkyunkwan)
저널정보
한국유방암학회 Journal of Breast Disease Journal of Breast Disease 제3권 제1호
발행연도
2015.6
수록면
8 - 15 (8page)
DOI
http://dx.doi.org/10.14449/jbd.2015.3.8

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Purpose: Neoadjuvant chemotherapy (NAC) frequently results in shrinkage of the primary tumor. It is not easy to perform breast-conserving surgery (BCS) after NAC, based on tumor extent alone. We identified the clinicopathological factors associated with positive margins on frozen or permanent sections in patients undergoing BCS after NAC. Methods: The records of 151 patients who had BCS after NAC between 2005 and 2010 were reviewed. All patients underwent subsequent imaging work-up including breast magnetic resonance imaging, ultrasound, and breast mammography at the midpoint and/or the end of NAC. Positive resection margins on frozen or permanent sections were considered to be due to the presence of either invasive carcinoma or in situ carcinoma. The relationship between the microscopic margin status and clinicopathological factors was analyzed when positive margins were detected. Results: Of 151 patients, 39 (25.8%) were diagnosed with a pathological complete response, while 135 patients (89.4%) had a negative margin on both frozen and permanent sections and 16 (10.6%) had a positive margin on frozen or permanent sections. Of the 16 patients, 14 finally obtained negative margins after additional excision and two (1.3%) had positive margins due to in situ carcinoma. Multivariate analysis revealed that clinical multifocality after NAC (p=0.006), and hormonal receptor (HR) positivity (p=0.028) were significantly associated with positive margins on frozen or permanent sections, but were not associated with tumor size after NAC, specimen volume, or human epidermal growth factor receptor 2 positivity. Conclusion: We propose that HR positivity and clinical multifocality after NAC are predisposing factors for positive margins in patients undergoing BCS after NAC. It is necessary to obtain safe resection margins to avoid positive margins in these patients.
#Breast neoplasms #Neoadjuvant therapy #Segmental mastectomy #Surgical margins

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참고문헌 (30)

참고문헌 신청
Fisher B / 2002 / Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer / N Engl J Med 347:1233~1241 google schola Fisher B / 1997 / Effect of preoperative chemotherapy on local-regional disease in women with operable breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-18 / J Clin Oncol 15:2483~2493 google schola Rastogi P / 2008 / Preoperative chemotherapy: updates of National Surgical Adjuvant Breast and Bowel Project Protocols B-18 and B-27 / J Clin Oncol 26:778~785 google schola Rouzier R / 2001 / Primary chemotherapy for operable breast cancer:incidence and prognostic significance of ipsilateral breast tumor recurrence after breast-conserving surgery / J Clin Oncol 19:3828~3835 google schola Smith IE / 2001 / Preoperative/neoadjuvant medical therapy for early breast cancer / Lancet Oncol 2:561~570 google schola

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