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Extent and Role of Margin Control for DCIS Managed by Breast-Conserving Surgery

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Book cover Ductal Carcinoma In Situ and Microinvasive/Borderline Breast Cancer

Abstract

The appropriate negative margin width for ductal carcinoma in situ (DCIS) remains a controversial issue for patients treated both with and without adjuvant radiation therapy. The optimal margin minimizes the potential residual disease in the breast and the risk of local recurrence while maximizing the cosmetic outcome. Studies consistently report worse local control for positive margins but are inconsistent in identifying a negative margin width greater than no ink on tumor that is appropriate for all patients with DCIS. Deciding the appropriate margin for a patient with DCIS is a multifactorial process. Here, we review important clinical and pathological factors that impact patient-specific margin management including the volume of DCIS near a margin, the anatomic location of close margins within the breast, the plan for adjuvant therapy, the appearance of a post-procedure mammogram, tissue handling, and margin assessment.

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  1. Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 300 East 66th Street, 10065, New York, NY, USA

    Melissa Pilewskie MD & Monica Morrow MD

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  1. Comprehensive Cancer Center, University of Michigan Health System, Ann Arbor, Michigan, USA

    Lisa A. Newman

  2. Comprehensive Cancer Center, University of Michigan Health System, Ann Arbor, Michigan, USA

    Jessica M. Bensenhaver

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Pilewskie, M., Morrow, M. (2015). Extent and Role of Margin Control for DCIS Managed by Breast-Conserving Surgery. In: Newman, L., Bensenhaver, J. (eds) Ductal Carcinoma In Situ and Microinvasive/Borderline Breast Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2035-8_7

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