Effect of margin width on local recurrence in triple-negative breast cancer patients treated with breast-conserving therapy Journal Article


Authors: Pilewskie, M.; Ho, A.; Orell, E.; Stempel, M.; Chen, Y.; Eaton, A.; Patil, S.; Morrow, M.
Article Title: Effect of margin width on local recurrence in triple-negative breast cancer patients treated with breast-conserving therapy
Abstract: Background. The effect of increasing negative margin width after breast-conserving therapy (BCT) on local recurrence (LR) is controversial. LR rates vary by subtype, with the highest rates seen in triple-negative breast cancer (TNBC). This study examined LR rates in relationship to margin width in TNBC treated with BCT. Methods. Women with TNBC who underwent BCT between 1999 and 2009 were identified. Margins were defined as positive (ink on tumor), 0.1-2.0, and 2 mm. Patients with positive margins were excluded. Statistical comparisons were by t test, Fisher's exact test, and Wilcoxon rank sum test. Cumulative incidence of LR was compared by competing-risks methodology. Results. Of 535 cancers, 71 had margins ≤2 mm and 464 had margins >2 mm. At a median follow-up of 84 months (range 8-165 months), there were 37 local, 18 regional, and 77 distant recurrences or deaths as first events. Ten patients had a locoregional recurrence before planned radiotherapy and were excluded from cumulative incidence analyses. The cumulative incidence of LR at 60 months for margins ≤2 mm was 4.7 % (95 % confidence interval 0-10.0) and for >2 mm was 3.7 % (1.8, 5.5) (p = 0.11). After controlling for chemotherapy and tumor size, there was no difference in LR between the two margin groups (p = 0.06). A difference in the risk of distant recurrence or death was not observed (p = 0.53). Conclusions. Margin width of >2 mm was not associated with reduced LR rates. These data support a negative margin definition of no ink on tumor, even in this high-risk TNBC cohort. © 2013 Society of Surgical Oncology.
Keywords: adult; middle aged; major clinical study; cancer recurrence; fluorouracil; methotrexate; follow up; tumor volume; cyclophosphamide; partial mastectomy; anthracycline; triple negative breast cancer; human; female; article
Journal Title: Annals of Surgical Oncology
Volume: 21
Issue: 4
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2014-04-01
Start Page: 1209
End Page: 1214
Language: English
DOI: 10.1245/s10434-013-3416-5
PROVIDER: scopus
PUBMED: 24327132
PMCID: PMC4349354
DOI/URL:
Notes: Cited By (since 1996):4 -- Export Date: 1 August 2014 -- CODEN: ASONF -- Source: Scopus
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MSK Authors
  1. Sujata Patil
    511 Patil
  2. Alice Yoosun Ho
    122 Ho
  3. Monica Morrow
    772 Morrow
  4. Anne Austin Eaton
    122 Eaton
  5. Michelle Moccio Stempel
    153 Stempel
  6. Emily Lauren Orell
    3 Orell
  7. Melissa Louise Pilewskie
    112 Pilewskie
  8. Yu Chen
    3 Chen