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Volume 13 Supplement 2

IX Madrid Breast Cancer Conference

Poster presentation | Open | Published:

Oestrogen receptor status predicts for local recurrence following wide local excision for breast tumours

Introduction

Status of the surgical margins following wide local excision for breast cancer remains one of the strongest predictors of local recurrence. In our practice, a margin of 1 mm and more is considered adequate. In this study, we aim to determine whether clinicopathological factors other than surgical margins contribute to the risk of local recurrence.

Methods

A retrospective review was performed of 548 consecutive patients who underwent wide local excision for invasive carcinoma or ductal carcinoma in situ (DCIS) from 1 January 2004 to 31 December 2008. Surgery was not routinely offered to patients with margins of 1 mm or more. All patients with wide local excision received postoperative whole breast irradiation, inclusive of a boost to the tumour bed.

Results

Local recurrence developed in 20% of those with involved margins, as compared with 8.7% of those with close margins, and 5.4% of those with margins of 1 mm and more. Although local recurrence was more likely with an involved or close surgical margin, this reached only borderline significance (P = 0.05). Oestrogen receptor (ER) status was found to be an independent predictor of local recurrence, with ER-negative tumours being three times more likely to recur (P < 0.01, OR = 0.30, 95% CI = 0.13 to 0.66). There was no correlation with a triple-negative phenotype or other clinicopathological factors.

Conclusion

A margin of 1 mm or more appears to be adequate following wide local excision. However, ER status emerged as a stronger predictor for local recurrence and alone remained significant on multivariate analysis.

Author information

Correspondence to JWK Lee.

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Keywords

  • Breast Cancer
  • Oestrogen Receptor
  • Local Recurrence
  • Breast Tumour
  • Strong Predictor