Der Resektionskantenstatus invasiver Mammakarzinome und seine Einflussfaktoren

Fragestellung: In zahlreichen Studien wurden Prognosefaktoren für das Auftreten von Lokalrezidiven untersucht und identifiziert. Einer der wichtigsten ist der Resektionskantenstatus. Weitaus seltener untersucht sind patientenbezogene und tumorbiologische Faktoren die das Risiko einer insuffizienten...

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Bibliographic Details
Main Author: Adam, Yasmin
Contributors: Barth, Peter Josef (Prof. Dr.) (Thesis advisor)
Format: Doctoral Thesis
Published: Philipps-Universität Marburg 2011
Online Access:PDF Full Text
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Background: Many risk factors for local recurrence in breast cancer have been identified, the most important one seems to be the resection margin status. But are there valid predictive factors that may help identify patients at risk for positive resection margin status? Methods: 227 female patients with either invasive ductal breast carcinoma (IDC) or invasive lobular breast carcinoma (ILC) that underwent breast conserving therapy (BCT) or mastectomy at the university hospital Marburg in 2006 were included. 27 different biological and tumorbiological characteristics were tested in univariate and multivariate analysis using the pearson chi square test and the binary logistic regression model. Results: The multivariate analysis identified tumor size (p = 0,003), surgical therapy (BCT vs. mastectomy) (p = 0,001), length of the resection specimen (p = 0,045) and simultaneous DCIS (p = 0,001) as significant independent predictive factors of the occurrence of positive resection margins. Conclusion: Positive resection margins are more likely to occur in patients with larger tumors, undergoing BCT than mastectomy and with simultaneous DCIS additional to the ILC/IDC. The risk for positive margins lessens with a wider excision. Therefore it is important to identify the volume of the tumor mass and the presence of DCIS carefully prior to the surgical therapy, to adequately choose the safest width of resection.