Clinical Studies Of Margin Status And Long Term Results Of Breast-Conserving Surgery

Objective:The margin status serves as a surrogate marker of residual disease in the breast and has an impact on patient risk of in-breast tumor recurrence(IBTR).Immediate intraoperative margin assessment(IOA)with frozen section is an important method to evaluate the margin status.Through the retrospective analysis of margin status and long term results including recurrence and metastasis after breast-conserving surgery,to study the impact of IOA and positive margin.Methods:660 patients intending to receiving breast-conserving surgery between 2000 January and 2016 June were collected.The frequency of re-resection,the impact of immediate intraoperative margin assessment with frozen section and the long term results of breast-conserving surgery especially recurrence and metastasis were analyzed.Results:94.88%patients finished the breast-conserving surgery,14.76%cases had positive margins at first pathologic examination.3.87%cases had false negative margins and were supposed to have addition surgery.The follow-up duration ranged from 4?166 months(mean 37 months),the 3-year survival rate was 3.70%,recurrence rate was 0.94%,metastasis rate was 2.97%.The patients who had lymphatic metastasis has higher recurrence rate than lymph node-negative patients.There was no differences in recurrence between different age,tumor size,pathological types and whether positive margins existed in the operations.The rate of metastasis was higher in cases which had False positive margins than the ones which never had positive margins.Conclusion:Immediate intraoperative margin assessment(IOA)with frozen section can reduce the positive margin after surgery significantly,thus reducing the rate of addition surgery.lymphatic metastasis can increase the risk of recurrence.False positive margins can increase the rate of metastasis,but not with recurrence.The existence of positive margins has no impact on the rate of recurrence and metastasis.