caa a22 4500 445338598 CHVBK 20180317142804.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1245/s10434-011-1802-4 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1802-4 The Safety of Multiple Re-excisions after Lumpectomy for Breast Cancer [Elektronische Daten] [Suzanne Coopey, Barbara Smith, Stephanie Hanson, Julliette Buckley, Kevin Hughes, Michele Gadd, Michelle Specht] Background: Breast cancer patients may undergo multiple re-excisions after lumpectomy in an attempt to obtain clear margins and avoid mastectomy. We sought to determine the overall local recurrence rate and surgical outcome of patients undergoing two or more re-excisions and to identify predictors of success in attaining clear margins. Methods: Retrospective review of breast cancer patients who underwent lumpectomy for invasive cancer or ductal carcinoma in situ (DCIS) from 1997 to 2007. Patients who underwent two or more re-excisions were identified and analyzed. Results: We identified 3,737 patients who underwent lumpectomy over this 10-year period. 875 (23.4%) had close or positive margins requiring a second procedure; 797 (91.1%) had a re-excision; and 78 (8.9%) went directly to mastectomy. Seventy patients underwent multiple re-excisions; 66 patients had 2 re-excisions, 3 patients had 3 re-excisions, and 1 patient had 4 re-excisions. 70% (49/70) of multiple re-excision patients achieved clear margins (26 DCIS, 35 T1, 8 T2, and 1 T3 tumors). All 49 patients who successfully treated with multiple re-excisions received radiation. At a median follow-up of 64 months, 1 of 49 (2.0%) patients had an in-breast recurrence, and 1 of 49 (2.0%) patients had a distant recurrence. Statistically significant risk factors for persistently involved margins after two re-excisions included multifocality and positive lymph node status. Conclusion: Multiple re-excisions to obtain clear margins are a safe alternative to mastectomy for women with invasive cancer or DCIS. There is an acceptably low risk of local and systemic failure when negative margins are ultimately achieved. Society of Surgical Oncology, 2011 Coopey Suzanne Department of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA aut Smith Barbara Department of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA aut Hanson Stephanie Department of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA aut Buckley Julliette Department of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA aut Hughes Kevin Department of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA aut Gadd Michele Department of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA aut Specht Michelle Department of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA aut Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3797-3801 1068-9265 18:13<3797 2011 18 10434 https://doi.org/10.1245/s10434-011-1802-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1802-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Coopey Suzanne Department of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA aut NATIONALLICENCE 700 1- Smith Barbara Department of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA aut NATIONALLICENCE 700 1- Hanson Stephanie Department of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA aut NATIONALLICENCE 700 1- Buckley Julliette Department of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA aut NATIONALLICENCE 700 1- Hughes Kevin Department of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA aut NATIONALLICENCE 700 1- Gadd Michele Department of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA aut NATIONALLICENCE 700 1- Specht Michelle Department of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3797-3801 1068-9265 18:13<3797 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer