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The Clinical and Histopathological Significance of Performing Surgical Cavity Random Biopsy in Breast Conserving Surgery on Disease Course and Local Recurrence

Samir Rahmani, Joshua Brown* and Raffat Gendy

Objective: Surgical treatment of breast cancer has changed dramatically in recent years. The National Institutes of Health Consensus Panel confirmed that breast-conservation surgery (BCS) is as effective as mastectomy in overall patients’ survival. Our aim was to assess the clinical and pathological value of performing surgical cavity random biopsies (SCRB) in BCS and their impact on the subsequent management.

Methods: A retrospective study was conducted on 494 patients who had BCS in our firm between 2001 and 2006. Outcome measures were examined at 3,4,5 years follow up period for each patient. Tumour immunohistochemistry, adjuvant therapy, recurrence rate and demographic data were collected and represented with Pearson’s chi-squared test.

Results: The median age was 59 years. Out of 494, 23 patients (4.65%) had positive SCRB whom all had subsequent surgical intervention plus adjuvant therapy. 7 patients had total mastectomy, 13 had re-excision of positive margins and only 3 had axillary node clearance. Recurrence rate was reported in 7 patients only (1.41%) and the overall mean survival time for all patients was 74.585 months (95% C.I 73.839-75.332).

Conclusion: Our practice of performing SCRB had changed the management of 23 patients and revealed an excellent recurrence rate of only 1.41% which is below the national figures reported in the literature (7-9%). SCRB is a reliable method of determining margin status, minimising re-excision and reducing overall recurrence rate.