A total of 161 patients with clinical stage I and II breast cancer received breast-conserving therapy between August 1991 and December 1997, and local recurrence occurred in five patients. The actuarial local control 5 years after breast-conserving surgery was 96.6%. We studied microscopic surgical margins of resected specimens in patients with breast-conserving surgery to determine whether the surgical margin was a risk factor for local recurrence in the conserved breast. Microscopic margins were negative in 125 (78%) of 161 patients and positive in 36 (22%). There were no differences between patients with positive surgical margins and those with negative surgical margins in age at operation, tumor size, clinical stage, lymph node status, estrogen receptor status, or distance from tumor to nipple. Local control was significantly better in the surgical margin-negative patients than in the surgical margin-positive patients. We conclude that microscopic surgical margin is a risk factor for local recurrence in the conserved breast.

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