Microscopic tumor cells in re-excision tissue by conservative surgery in breast cancer
Authors:
J. Gatěk 1; P. Vážan 2; D. Vrána 3; B. Dudešek 1; J. Duben 1
Authors‘ workplace:
Chirurgické oddělení nemocnice Atlas Zlín, Univerzita Tomáše Bati ve Zlíně
přednosta: doc. MUDr. J. Gatěk, Ph. D.
1; CGB laboratoř Zlín
přednosta: prim MUDr. D. Žiak
2; Onkologická klinika LF Univerzity Palackého, Olomouc
přednosta: prof. MUDr. B. Melichar, Ph. D.
3
Published in:
Rozhl. Chir., 2017, roč. 96, č. 8, s. 334-339.
Category:
Original articles
Overview
Introduction:
Conservative procedures in early breast carcinoma are a safe alternative to mastectomy. The resection line is controversial, as well as the presence of residual malignant cells in the breast after excision and their influence on local recurrence. The aim of the study was to assess the presence of residual cells in re-excised tissues near positive resection lines, in the distance up to 2 mm, and 2–5 mm. The distance of more than 5 mm was evaluated as free margin.
Method:
All patients operated on in Atlas Hospital from 2004 to 2008 using conservative surgery were included in study. The resection line and the presence of residual malignant cells were followed in positive margins and in the distance of the resection line from the tumour up to 2 mm, and 2–5 mm.
Results:
The conservative procedure was indicated 330 times, and 78 patients were re-operated for insufficiently free margins. The conservative procedure was completed 311 times, and mastectomy was done as the final procedure in 19 cases. Positive resection line was found 10 times. Distance up to 2 mm occurred 12 times and 2−5 mm 56 times. In all re-operated patients, presence of malignant cells in the re-excised tissue was found 31 times (39.7%). Repeated surgery for positive line, i.e. tumour present in the resection line, was done 10 times while malignant cells were found in all patients; for the distance up 2 mm, repeated surgery was done 12 times and 3 cases were positive (25%). For the distance of 2–5 mm, repeated excision occurred 56 times and 18 cases were positive, i.e. 32.1%.
Conclusion:
For the resection line “no tumour in contact with ink”, presence of malignant cells in breast tissue must be expected in one third of the cases.
Key words:
breast carcinoma – conservative surgery – residual malignant cells
Sources
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