Erschienen in:
06.08.2019 | ASO Author Reflections
ASO Author Reflections: Margin Analysis and Breast-Conserving Surgery
verfasst von:
Jessica C. Gooch, MD, Freya Schnabel, MD
Erschienen in:
Annals of Surgical Oncology
|
Sonderheft 3/2019
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Excerpt
Positive lumpectomy margins in breast-conserving surgery (BCS) increase the risk for local recurrence and are an indication for reoperation in breast cancer patients.
1 Re-excision procedures may delay the initiation of other cancer treatments and increase costs to the healthcare system.
1 In addition, a return to the operating room to remove additional tissue not only exposes the patient to the risks of a second surgery but also increases the likelihood of a poor cosmetic outcome. There are multiple factors that have been proposed to increase the risk of a positive margin, including tumor size, proportion of ductal carcinoma in situ in the specimen, multifocal disease, increased tissue density, and lobular histology.
2,
3 Previous approaches to intraoperative margin management include shaved margins of all six surfaces of the lumpectomy cavity, intraoperative pathology consultation, and selective margin excision based on intraoperative specimen x-ray and surgeon judgment. Despite these approaches, positive margins affect at least 20–30% of patients undergoing breast conservation.
4 …