The relationship between surgical factors and margin status after breast-conservation surgery for early stage breast cancer

BACKGROUND: The study's aim was to identify technical factors that are predictive of negative margins after breast-conserving surgery (BCS). METHODS: This was a retrospective, cohort study of patients who underwent BCS for early-stage cancer from 2000 to 2002. Pathological and specific surgical factors were compared with margin status. Univariate and multivariate regression analyses were performed. RESULTS: Four hundred eighty-nine cases were reviewed. The positive margin rate after the initial surgery was 26%. In univariate analysis, lobular histology, size, grade, multifocality, and the presence of EIC and LVI were associated with positive margins (P < .05). The absence of cavity margin dissection and specimen orientation labeling, the absence of a confirmed diagnosis, and smaller volumes of excision were also associated with positive margins (P < .05). In multivariate analysis, confirmed diagnosis, small tumor size, ductal histology, absence of LVI and multifocality, palpability, cavity margin dissection, and larger volumes of excision were predictors of negative margins. CONCLUSIONS: This study shows that specific surgical factors are predictive of margin status. Both tumor and technical factors should be considered when planning BCS.