SURGICAL MARGIN STATUS AND ITS IMPACT ON RECURRENCE IN BREAST-CONSERVING SURGERY FOR EARLY-STAGE CARCINOMA

Abstract

Background: Breast-conserving surgery (BCS) is the preferred surgical approach for early-stage breast carcinoma, aiming to achieve tumor clearance while preserving breast tissue. Objective: This study evaluates the relationship between surgical margin status and recurrence rates among patients undergoing BCS for early-stage breast cancer. Methods: A retrospective, cross-sectional study was conducted at Shaikh Sayed Hospital, Lahore from December 2024 to May 2025, including 105 patients with histologically confirmed early-stage (Stage I–II) breast carcinoma treated with BCS. Data were collected on demographic variables, tumor characteristics, margin status, adjuvant therapies, and recurrence outcomes.  Results: The mean age of patients was 52.4 ± 9.6 years, with females comprising 76% of the cohort. Negative margins were achieved in 89 patients (84.8%), close margins in 8 (7.6%), and positive margins in 8 (7.6%). The recurrence rate was 6.7% in the negative margin group, 25% in the close margin group, and 50% in the positive margin group (p < 0.001). The 5-year recurrence-free survival rates were 92%, 75%, and 50% for negative, close, and positive margins, respectively. Cox regression identified positive margin status (HR: 3.8, 95% CI: 2.1–6.9, p < 0.001), larger tumor size (HR: 2.2, p = 0.03), and higher tumor grade (HR: 1.9, p = 0.04) as independent predictors of recurrence. Postoperative radiation therapy was administered to 97% of patients and hormonal therapy to 60%, contributing to improved local control. Conclusions: It is concluded that surgical margin status is a significant determinant of recurrence in patients undergoing BCS for early-stage breast carcinoma. Negative margins are strongly associated with lower recurrence rates and better survival outcomes, while positive margins markedly increase recurrence risk.