SURGICAL MANAGEMENT OF Tx BREAST CANCER: IS BREAST CONSERVATION AN OPTION?

Aim: Unfortunately, lumpectomy is still the most diagnostic tool for breast carcinoma in Egypt. Management of Tx breast carcinoma is still a controversial issue. Most of these patients are doomed to undergo mastectomy. The aim of this study is to analyze patients with Tx breast carcinoma after having their definitive treatment as regard residual disease in the lumpectomy cavity and factors affecting it. Methods: 60 patients with Tx breast carcinoma who had lumpectomy for a localized breast lump and were proved to be invasive breast cancer were subjected to this study. They were operated from January 2001 to December 2007. Pathologic and patient characteristics were all reviewed. Results: In this sample, the median age of the patients was 45 year, and the median tumor size was 3 cm. 52 patients (86.7%) had mastectomy and 8 patients (13.3%) had conservative breast therapy (CBT). Residual disease was present in 22 patients (36.7%). Margins less than 5 mm had residual tumors in 90.9% of cases. Tumors larger than 2.5 cm in diameter showed residual disease in 52.9% of cases. The other independent factors as age, sex, laterality and grade of tumor had no statistically significant effect on residual tumor. Conclusion: Mastectomy is not the only option for management of Tx breast cancer. Breast conserving therapy is still a valid option provided that a wide safety margin is excised with definitive negative margins