Breast biopsy techniques and adequacy of margins
J. H. Ngai, G. W. Zelles, G. J. Rumore, J. E. Sawicki and R. S. Godfrey
Department of Surgery, Kaiser Permanente Medical Center, Oakland, Calif. 94611-5693.
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.
