Surgical margin size did not appear to be associated with locoregional recurrence for patients with breast cancer who underwent breast-conserving surgery and neoadjuvant chemotherapy, a retrospective, single-institution study found. The results were recently reported in BMC Cancer.

Patients with breast cancer who received neoadjuvant chemotherapy between January 2008 and April 2018 were identified from an institutional database.

A total of 161 patients were eligible for analysis, all of whom were Asian women. The cohort had a median age of 47.4 years (range, 25.4-7.3 years) and most patients had grade II (51.3%) or III (36%) disease.

Most patients had surgical margins of more than 2 mm (112 patients), and the remaining had margins of less than 1 mm (28 patients) or between 1 and 2 mm (21 patients). Overall, 16 patients (9.9%) had locoregional recurrence and 27 (16.8%) had distant metastases.


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The recurrence-free survival (RFS) was not significantly different between patients who had margins of more than 2 mm and patients who had margins of 2 mm or less (P =.335). Similarly, RFS was not significantly different between patients who had margins of 1 mm or more and patients who had margins of less than 1 mm (P =.150).

Event-free survival (EFS) was also not associated with margin size. A multivariate analysis identified only lymph node status as a significant predictor of EFS (HR, 3.374; 95% CI, 1.020–11.155; P =.046).

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The study authors cautioned that further studies with greater sample sizes are necessary to determine the safe surgical margin with neoadjuvant chemotherapy and breast conserving surgery.

In the absence of multiple scattered microscopic tumor foci, a negative margin of no ink on tumor may be “sufficient” for stage I–III invasive breast cancer treated with neoadjuvant chemotherapy and breast-conserving surgery, the study authors concluded.

Reference

Lin J, Lin K, Wang Y, Huang L, Chen SL, and Chen D. Association of surgical margins with local recurrence in patients undergoing breast-conserving surgery after neoadjuvant chemotherapy [published online May 20, 2020]. BMC Cancer. doi: 10.1186/s12885-020-06955-6