Breast cancer with close surgical margins

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Wider negative margins do not improve local control for ductal carcinoma in situ or invasive carcinoma when they are treated with lumpectomy and radiation therapy, our recent literature review shows. However, ambiguity regarding margin width in such cases persists, leading to high rates of re-excision. Changes in our understanding of the biology of local recurrence LR have prompted a reexamination of factors determining optimal surgical margins in breast-conserving therapy BCT.

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My suggestion: There is no difference in survival of breast cancer patients treated with either mastectomy or with breast conservation therapy combined with external beam radiotherapy. A positive margin s is an important factor contributing to the increased risk of local recurrence. However, in published literature, there is a lack of consensus on the definition of acceptable margin s.

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Clin Surg. We analyzed literature studies to determined re-operation rate and type of re-operation, differences according to treatment periods, histologic tumor type and results after initial BCS with oncoplasty. Methods: We included 15 studies with highest numbers of patients treated from to and our institutional data from our institutional data base including patients treated from year to

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When breast cancer is surgically removed during a surgical biopsy, lumpectomy or mastectomya rim of normal tissue surrounding the tumor is also removed. This rim is called a margin. Learn about mastectomy and tumor margins. A pathologist studies the tissue removed during surgery under a microscope and determines whether or not the margins contain cancer cells.

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If you require a lumpectomy for breast cancer, your surgeon will remove the tumor and a border of tissue surrounding it called the surgical margin. A pathologist will then examine the tissue to determine if all the cancer cells in that area are gone or if further treatment is needed. If cancer cells are found anywhere between the tumor itself and the outer edge of the margin, additional surgery may be recommended.

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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.

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A resection margin or surgical margin is the margin of apparently non-tumorous tissue around a tumor that has been surgically removed, called " resected ", in surgical oncology. The resection is an attempt to remove a cancer tumor so that no portion of the malignant growth extends past the edges or margin of the removed tumor and surrounding tissue. These are retained after the surgery and examined microscopically by a pathologist to see if the margin is indeed free from tumor cells.

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By Alice Goodman January 25, Advertisement. A final positive margin of any width was associated with a 2. The study was based on data from 11, women aged 18 to 75 years who underwent breast-conserving surgery for unilateral invasive breast cancer and no prior cancer. The women were also treated with radiation therapy and could elect to receive systemic adjuvant treatment.

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Lumpectomy margins are the rim of normal tissue surrounding the cancer tumor that is often removed with the tumor during the surgery to ensure the cancer is completely gone. After the procedure, a pathologist examines the removed tissue to check for remaining cancer cells in the lumpectomy margins. Margins free of cancer are considered clean, clear or negative, which is the goal of the surgery.

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The question that remains now is whether this recommendation is still correct. The researchers conducted a systemic review of studies published between and that had a minimum follow-up of 50 months, explicit pathologic definition of margin status and local recurrence reported in relation to margin status. Researchers defined positive margins as invasive cancer or ductal carcinoma in situ at the surgical margin; negative margins as no tumor within specified distance from the margin; and close margins as no tumor on ink, but tumor in the less-than-specified distance from the margin.

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