Sampling of secondary margins decreases the need for re-excision after partial mastectomy

Guidroz, Julie A.; Larrieux, Gregory; Liao, Junlin; Sugg, Sonia L.; Scott‐Conner, Carol E. H.; Weigel, Ronald J.

doi:10.1016/j.surg.2011.07.064

Cited by 10 publications

(5 citation statements)

References 15 publications

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“…In another study, residual tumour was identified in 38% cases with tumour at margin, 21% in cases with margins measuring between 0.1 and 0.9 mm and in 14% in cases with margins from 1.0 to 1.9 mm . Confirming this, a number of studies have shown that shaved margins revealed residual tumour in cases with less than 2 mm free margins, but the incidence decreased with 2 mm or more margins . Tables and show data to support the view that wider margins not only decrease local recurrence rate but also decrease incidence of residual tumour tissue after first excision.…”

Section: Studies With a 2‐mm Margin Width As An Optimal Negative Marginmentioning

confidence: 69%

“…19 Confirming this, a number of studies have shown that shaved margins revealed residual tumour in cases with less than 2 mm free margins, but the incidence decreased with 2 mm or more margins. [64][65][66][67][68] Tables 5 and 6 show data to support the view that wider margins not only decrease local recurrence rate but also decrease incidence of residual tumour tissue after first excision.…”

Section: Is 'No Ink On Tumour' Acceptable For Bcs For Dcis?mentioning

confidence: 69%

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Breast conservation in ductal carcinoma in situ (DCIS): what defines optimal margins?

et al. 2016

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The introduction of mammographic screening has resulted in a rise in the detection rate of ductal carcinoma in situ (DCIS), currently accounting for one-fifth of screen-detected breast cancers. Although 60-70% of DCIS are treated with breast-conserving surgery (BCS) with or without radiotherapy, the frequency of subsequent surgery to re-excise positive margins in order to reduce the probability of recurrences remains high. DCIS recurrence is associated not only with financial, health and psychological implications; approximately half these recurrences are invasive disease. An appropriate margin width for patients undergoing BCS for invasive breast cancer has been largely agreed. Although there is a perception that such recommendations may be applicable to DCIS, major differences exist which may affect this application. Importantly, DCIS patients often do not receive systemic adjuvant (endocrine) therapy and not all receive radiotherapy in routine practice. There is evidence that wide margins (i.e. >10 mm) confer better protection against recurrence than positive (i.e. 0 mm) margins; however, there remains a debate concerning the optimum margin width between 0 and 10 mm. Previous studies have demonstrated that radiation therapy may not compensate for lack of re-excision in those patients with positive or close margins, while wide margins will inevitably compromise cosmesis and patients' body image perception. This review aims to address the clinical question of the minimal margin width in DCIS treated with BCS that is associated with the lowest recurrence rate and when, therefore, further surgical intervention for re-excision can be safely avoided. A range of clinical circumstances that might affect this are considered.

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Section: Studies With a 2‐mm Margin Width As An Optimal Negative Marginmentioning

confidence: 69%

Section: Is 'No Ink On Tumour' Acceptable For Bcs For Dcis?mentioning

confidence: 69%

Breast conservation in ductal carcinoma in situ (DCIS): what defines optimal margins?

et al. 2016

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“…Guidroz reported that surgeon assessment of the lumpectomy cavity with selective excision of additional tissue resulted in decreased need for second surgery following primary lumpectomy [22]. Simply employing a systematic removal of six additional shave margins (covering the entire cavity) from lumpectomy cavities halved the incidence of residual disease compared to patients who did not have the additional tissue submitted [23].…”

Section: Effect Of Different Methods Of Margin Procurementmentioning

confidence: 99%

Evaluation of Resection Margins in Breast Conservation Therapy: The Pathology Perspective—Past, Present, and Future

Emmadi

Wiley

2012

International Journal of Surgical Oncology

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Tumor surgical resection margin status is important for any malignant lesion. When this occurs in conjunction with efforts to preserve or conserve the afflicted organ, these margins become extremely important. With the demonstration of no difference in overall survival between mastectomy versus lumpectomy and radiation for breast carcinoma, there is a definite trend toward smaller resections combined with radiation, constituting “breast-conserving therapy.” Tumor-free margins are therefore key to the success of this treatment protocol. We discuss the various aspects of margin status in this setting, from a pathology perspective, incorporating the past and current practices with a brief glimpse of emerging future techniques.

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“…Par ailleurs, le recours à l'oncoplastie dans ce contexte (CCIS) pourrait ré duire le risque de reprise en mastectomie avec absence de lé sion ré siduelle sur la piè ce opé ratoire de mastectomie (« mastectomie blanche »). [14] < 2 mm 366 66,7 Wallace et al [27] < 5 mm 8 38 Chagpar et al [28] < 1 mm 109 29 Guidroz et al [29] < 2 mm 299 29,4 Gilleard et al [30] < 2 mm 215 33 Devouge et al [24] < 2 mm 50 56…”

Section: Place Spe´cifique De L'oncoplastie Pour Le Ccisunclassified

Place de l’oncoplastie dans la prise en charge des carcinomes canalaires in situ

Bauwens

Azaïs

Devouge

et al. 2015

Gynécologie Obstétrique & Fertilité

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Sampling of secondary margins decreases the need for re-excision after partial mastectomy

Cited by 10 publications

References 15 publications

Breast conservation in ductal carcinoma in situ (DCIS): what defines optimal margins?

Breast conservation in ductal carcinoma in situ (DCIS): what defines optimal margins?

Evaluation of Resection Margins in Breast Conservation Therapy: The Pathology Perspective—Past, Present, and Future

Place de l’oncoplastie dans la prise en charge des carcinomes canalaires in situ

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