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16.03.2016 | Local-Regional Evaluation and Therapy (EP Mamounas, Section Editor) | Ausgabe 2/2016

Current Breast Cancer Reports 2/2016

Margins in Breast-Conserving Surgery for Early Breast Cancer: How Much is Good Enough?

Zeitschrift:
Current Breast Cancer Reports > Ausgabe 2/2016
Autoren:
Nehmat Houssami, M. Luke Marinovich
Wichtige Hinweise
This article is part of the Topical Collection on Local-Regional Evaluation and Therapy

Abstract

Breast-conserving therapy (breast-conserving surgery (BCS) and radiation therapy) is an effective treatment for early-stage breast cancer (BC). Whilst there is consensus that risk of local recurrence (LR) following BCS is increased if the surgical margins are positive (‘ink on tumour’), consensus on what constitutes adequate negative margins has been elusive despite studies spanning decades. Recent SSO–ASTRO guidelines have recommended ‘no ink on tumour’ as the standard for negative margins in BCS for invasive BC. These were underpinned by study-level meta-analysis reporting that a minimally defined negative margin width be adopted for BCS in invasive BC and showing that wider (than a minimum >1 mm) negative margins do not significantly reduce LR risk. Recommendations on a minimum margin width for ductal carcinoma in situ (DCIS) vary substantially from >1 to 10 mm or wider; evidence-based guidelines are being developed and are expected to address ‘how much is enough’ for margin width in DCIS.

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