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Breast Biopsy Techniques and Adequacy of Margins
John H. Ngai, MD;
Gary W. Zelles, MD;
Gregory J. Rumore, MD;
John E. Sawicki, MD;
Richard S. Godfrey, MD
Arch Surg. 1991;126(11):1343-1347.
Abstract
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• The change toward breast-conserving surgery for cancer has altered the role of the initial biopsy. We retrospectively analyzed two methods, traditional excisional biopsy (n=47) and lumpectomy (n=44) to evaluate their usefulness as the initial procedure for breast-conserving surgery. Lumpectomy required more time (mean±SEM, 53±3 minutes) than traditional biopsy (37±2 minutes). Margins were verified by microscopic examination to be clear in 73% of the patients in the lumpectomy group and in only 17% of patients in the traditional biopsy group. Patients in the lumpectomy group subsequently underwent more axillary dissections than patients in the traditional biopsy group (31% vs 4%, respectively) and fewer modified radical mastectomies (49% vs 71%, respectively). A correlation between extensive intraductal components and positive margins was found in the lumpectomy group. These data suggest that as the initial biopsy method, lumpectomy more often provides adequate margins and may decrease the number of subsequent procedures on the breast for breast-conserving surgery.
(Arch Surg. 1991;126:1343-1347)
Author Affiliations
From the Departments of Surgery (Drs Ngai, Zelles, and Godfrey) and Pathology (Drs Rumore and Sawicki), Kaiser Permanente Medical Center, Oakland, Calif.
Footnotes
Accepted for publication August 4, 1991.
Presented at the 44th Annual Cancer Symposium of the Society of Surgical Oncology, Orlando, Fla, March 25, 1991.
Reprint requests to the Department of Surgery, Kaiser Permanente Medical Center, 280 W MacArthur Blvd, Oakland, CA 94611-5693 (Dr Godfrey).
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