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Margins in breast cancer: How much is enough?
Author(s) -
Pilewskie Melissa,
Morrow Monica
Publication year - 2018
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.31221
Subject(s) - lumpectomy , medicine , margin (machine learning) , breast cancer , ductal carcinoma , radiation therapy , breast conserving surgery , surgical margin , cancer , mastectomy , oncology , carcinoma in situ , radiology , surgery , machine learning , computer science
The appropriate negative margin width for women undergoing breast‐conserving surgery for both ductal carcinoma in situ (DCIS) and invasive carcinoma is controversial. This review examines the available data on the margin status for invasive breast cancer and DCIS, and highlights the similarities and differences in tumor biology and standard treatments that affect the local recurrence (LR) risk and, therefore, the optimal surgical margin. Consensus guidelines support a negative margin, defined as no ink on tumor, for invasive carcinoma treated with breast‐conserving therapy. Because of differences in the growth pattern and utilization of systemic therapy, a margin of 2 mm has been found to minimize the LR risk for women with DCIS undergoing lumpectomy and radiation therapy (RT). Wider negative margins do not improve local control for DCIS or invasive carcinoma when they are treated with lumpectomy and RT. Re‐excision for negative margins should be individualized, and the routine practice of performing additional surgery to obtain a wider negative margin is not supported by the literature. Cancer 2018;124:1335‐41 . © 2018 American Cancer Society .