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Risk of compromised margins following breast conservation for invasive lobular carcinoma
Breast conservation is an achievable goal for the majority of women with breast cancer. However, the association of invasive lobular carcinoma with high rates of compromised margins in breast conservation makes choice of operation for these particular patients difficult. In a retrospective review of patients with invasive lobular or invasive ductal carcinoma, we demonstrate that compromised margins rate in invasive lobular disease is twice that of invasive ductal disease (49% vs 24%). Preoperative mammographic tumour size can help select patients who are more likely to benefit from breast conservation. Those identified as been at high risk of compromised margins are patients with a tumour size >1.5 cm mammographically or >2 cm pathologically, those with lymphovascular invasion, multifocality, or patients of a younger age. Imaging techniques tend to underestimate size, particularly in the case of ultrasound. Patients who request breast conservation should be made aware that that their particular tumour type makes them more susceptible to re operation and counselled accordingly.
Bibliographical reference: Dillon
MF et al.: "Identifying patients at risk of compromised margins
following breast conservation for lobular carcinoma",
Am J Surg, Volume 191, Issue 2,
Mary Dillon Department of Surgery, St Vincent’s University Hospital, Dublin, Ireland
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