Intraoperative pathological monitorization of surgical margins: A method to reduce local recurrences after conservative treatment for breast cancer

Local recurrences after conservative surgical treatment for breast cancer are not uncommon and cause negative influences on oncological prognosis and quality of life of the patients. Aiming to avoid this problem, we have developed the "intraoperative pathological monitoring of surgical margins" (IPMSM), in order to assure adequacy of resection. IPMSM is based on radiological, macroscopic, cytological and histological examination of the breast specimens in the operating room. We have evaluated 98 women with 100 tumors with clinical stage I-II breast cancer with indication of conservative surgery. The immediate reexcision was indicated in 40 cases and 6 of these have to be submitted to mastectomy. These patients were followed by a mean period of 42 months (range 3 to 99 months, median=22) and we have observed 1% of local recurrence. We compared this group of patients with a control group represented by 149 cases of breast cancer stages I-II treated by conservative surgery, but not submitted to IPMSM. In the control group, we observed 17 (11.4%) local recurrences after a follow-up period from 14 to 213 months (median of 126 months) (p=0.04). The IPMSM proved to be a safe and accurate method to prevent an additional surgery for insufficient margins and can reduce the recurrence rate.