(HealthDay News) — For early-stage invasive breast cancer, involved or close pathological margins after breast-conserving surgery are associated with an increased risk for distant and local recurrence, according to a review published online Sept. 21 in The BMJ.
James R. Bundred, from the University of Leeds in the United Kingdom, and colleagues conducted a systematic review and meta-analysis of literature to examine the association between margin involvement and recurrence in early-stage invasive breast cancer. Eligible studies reported on patients undergoing breast-conserving surgery for stages I to III breast cancer, with follow-up for a minimum of 60 months. A total of 68 studies with 112,140 patients with breast cancer were included.
The researchers found that 9.4 percent of patients had involved (tumor on ink) margins and 17.8 percent had tumor on ink or a close margin across all studies. Distant recurrence occurred at a rate of 25.4, 8.4, and 7.4 percent among patients with tumor on ink margins, patients with tumor on ink or close, and patients with negative margins, respectively. Tumor on ink margins were associated with increased distant and local recurrence compared with negative margins (hazard ratios, 2.10 and 1.98, respectively). Compared with negative margins, close margins were associated with increased distant and local recurrence (hazard ratios, 1.38 and 2.09, respectively) after adjustment for receipt of adjuvant chemotherapy and radiotherapy.
“These comprehensive data indicate the likelihood that inadequate margin widths result in higher risks of distant recurrence and breast cancer mortality, as well as increased local recurrence,” the authors write.