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Abstract <p>The effect of involved margins after breast cancer surgery on distant recurrence (DR) is unknown. We determined the association between margin width or involvement, DR and cancer deaths.</p> Patients and methods <p>Greater Manchester (GM) and the National Cancer Registry (NCRAS) cohorts were analysed. Margin status after curative surgery was measured. Cox-proportional hazards investigated factors associated with LR, DR and breast cancer deaths.</p> Results <p>In GM (2010–2014), 2295 (70.2%) patients had clear margins ( &gt; 2 mm), 302 (9.2%) close (1–2 mm) and 673 (20.6%) involved ( &lt; 1 mm) margins. 2030 patients underwent breast conservation surgery (BCS). After multivariable adjustment in BCS patients, involved margins had an increased hazard of DR (HR 1.73, 95% CI:1.03, 2.88, <i>p</i> = 0.037) and LR (HR 2.16, 95% CI:1.31, 3.58, <i>p</i> = 0.003). NCRAS data from 2010–2013 in 16,420 BCS patients included 3,913 patients (23.9%) with final margins &lt;1 mm. There were 642 deaths (3.9%) after 80.2 months median follow-up: 5.6% in patients with final margins &lt;1 mm and 3.4% with margins &gt;1 mm. After BCS, in 5246 patients who underwent chemotherapy after BCS, involved margins &lt;1 mm had a HR of 1.33 (CI 1.10–1.60, <i>p</i> = 0.003) for cancer death.</p> Conclusions <p>Margins &gt;1 mm were associated with lower DR and cancer deaths. Guidelines should recommend a minimum margin clearance of 1 mm.</p>

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Distant recurrence and margin involvement in invasive breast cancer

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月5日

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  • Sarah Michael,
  • John Broggio,
  • Sarah Bowers,
  • Jane Ooi,
  • Anne Armstrong,
  • Mohammed Absar,
  • Nikitas Dimipoulos,
  • Simon Ellenbogen,
  • Jacqui Gath,
  • Glen Martin,
  • Nigel James Bundred

摘要

Abstract

The effect of involved margins after breast cancer surgery on distant recurrence (DR) is unknown. We determined the association between margin width or involvement, DR and cancer deaths.

Patients and methods

Greater Manchester (GM) and the National Cancer Registry (NCRAS) cohorts were analysed. Margin status after curative surgery was measured. Cox-proportional hazards investigated factors associated with LR, DR and breast cancer deaths.

Results

In GM (2010–2014), 2295 (70.2%) patients had clear margins ( > 2 mm), 302 (9.2%) close (1–2 mm) and 673 (20.6%) involved ( < 1 mm) margins. 2030 patients underwent breast conservation surgery (BCS). After multivariable adjustment in BCS patients, involved margins had an increased hazard of DR (HR 1.73, 95% CI:1.03, 2.88, p = 0.037) and LR (HR 2.16, 95% CI:1.31, 3.58, p = 0.003). NCRAS data from 2010–2013 in 16,420 BCS patients included 3,913 patients (23.9%) with final margins <1 mm. There were 642 deaths (3.9%) after 80.2 months median follow-up: 5.6% in patients with final margins <1 mm and 3.4% with margins >1 mm. After BCS, in 5246 patients who underwent chemotherapy after BCS, involved margins <1 mm had a HR of 1.33 (CI 1.10–1.60, p = 0.003) for cancer death.

Conclusions

Margins >1 mm were associated with lower DR and cancer deaths. Guidelines should recommend a minimum margin clearance of 1 mm.