Breast cancer remains the most common malignancy in women, and breast-conserving surgery (BCS) with adjuvant radiotherapy is a standard treatment for early-stage disease. This study assessed the impact of positive surgical margins and secondary surgeries on local recurrence rates and patient outcomes. In this retrospective tumor registry-based study, 24,450 women were eligible for analysis. Of them, 18,082 underwent primary BCS only, 4836 underwent re-excision by BCS, and 1532 underwent re-excision by mastectomy following primary BCS. Our findings indicate that even though re-excision procedures were associated with higher local recurrence rates (HR 1.19; 95% CI 1.08–1.33), they did not significantly affect long-term survival (HR 0.98; 95% CI 0.87–1.10). This underscores the need for meticulous surgical practices to achieve clean margins initially, and suggests that the choice of surgical intervention should consider individual tumor characteristics and patient preferences to optimize oncological and aesthetic outcomes.
乳腺癌仍是女性最常见的恶性肿瘤，保乳手术联合辅助放疗是早期乳腺癌的标准治疗方案。本研究评估了手术切缘阳性及二次手术对局部复发率和患者预后的影响。这项基于肿瘤登记系统的回顾性研究共纳入24,450例符合分析条件的女性患者，其中18,082例仅接受初次保乳手术，4,836例在初次保乳术后接受再次保乳切除术，1,532例在初次保乳术后转为乳房切除术。研究结果显示，尽管再次切除手术与较高的局部复发率相关（风险比1.19；95%置信区间1.08-1.33），但并未显著影响患者的长期生存率（风险比0.98；95%置信区间0.87-1.10）。这强调了初次手术应通过精细操作确保切缘阴性，同时提示手术方式的选择需综合考虑个体肿瘤特征及患者意愿，以实现肿瘤学疗效与美学效果的最优化。
肿瘤(癌症)患者之家