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Title: Tumour bed positivity following breast-conserving surgery in breast cancer : risk factors and effect on patient outcome
Author: Malik, Hassan Zakria
Awarding Body: University of Glasgow
Current Institution: University of Glasgow
Date of Award: 2001
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This thesis is an exploration of certain aspects of breast-conserving surgery. It examines the risk factors as well as implications of local recurrence. All relevant published literature has been reviewed. The core of this thesis deals with a review of 752 patients who underwent breast-conserving surgery for invasive disease. Of these, 543 patients had tumour margin assessment performed by histopathological analysis of shavings from the residual cavity following initial wide local excision. The incidence of tumour bed positivity was 37%. A proportion of these patients underwent further surgery. At a mean follow-up of 52 months the local recurrence rate was 2%. Tumour bed positivity was found to be associated with symptomatic presentation; poorer tumour grade; lymphovascular invasion; extensive in-situ disease within the tumour and mammographically-detected casting calcification as well as absence of a nidus. Tumour bed positivity was found to predict for both poorer disease-free and distant disease-free survival. Furthermore, following introduction of tumour bed assessment the local recurrence rate fell from 16 to 2.5%. The implications of these findings are expanded upon in the following work.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral