The timing of surgery affects the detection of residual disease after wide local excision of breast carcinoma

Aims: To compare the frequency of residual tumour in the cavity wall in patients with positive resection margins undergoing either immediate re-excision (IR) at the time of surgery or delayed re-excision (DR) to investigate the effects of recent surgery on the detection of residual disease. Methods: Records of 125 patients who had undergone wide local excision with positive margins were examined. In 64 patients re-excision was performed immediately and in 61 it was delayed by 13–69 days. The presence or absence of residual disease in the re-excision specimens was recorded. Results: Residual tumour was detected in 40/64 (62%) and 20/61 (33%) DR specimens (P<0.001). DR specimens contained areas of fibrosis, fat necrosis and foreign body giant cell changes. Conclusions: The detection of residual disease is significantly lower in DR compared to IR specimens. Local repair mechanisms may account for this difference.