Optimal margins for breast-conserving surgery for ductal carcinoma in situ less certain-- Monica Smith
Wednesday, October 27, 2010 (Last Updated: 10/28/2010)
WEDNESDAY, Oct. 27 (HealthDay News) -- A free margin of 2 mm from the invasive tumor appears to be associated with a low risk of residual disease in patients undergoing breast-conserving surgery, according to research published in the November issue of the International Journal of Clinical Practice.
Stephen T. Ward, of the Good Hope Hospital in Sutton Coldfield, U.K., and colleagues assessed 161 patients who needed greater free margin width and were assigned to re-excision for the presence of residual disease, and then looked at the association with the original margin's width; they also looked for factors associated with close margins.
The researchers determined that the likelihood of finding residual disease in patients with a free margin of at least 2 mm from the invasive tumor was 2.4 percent, but that this likelihood was higher for ductal carcinoma in situ and that the odds were not improved by increasing the width of the free margin. Tumor size, lobular cancer type, vascular invasion, and nodal involvement appeared to be related to close margins.
"We suggest that a free margin of 2 mm from invasive tumor is adequate to minimize residual disease, whereas the equivalent free margin for ductal carcinoma in situ remains unclear. Patients with large tumors and lobular cancer type should be counseled at the time of first surgery concerning the higher risk of further excision and mastectomy," the authors write.
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