Controversies in pathology in early-stage breast cancer

Breast-conserving therapy is a reliable, evidenced-based approach for early-stage breast carcinoma. This article reviews the issues and limitations related to simple margin measurements, data supporting the association between the amount of carcinoma near the margin, and ipsilateral breast failure risk. Additional factors pertinent to radiation oncologists include extensive intraductal carcinoma, lymphovascular space invasion, atypical ductal hyperplasia, and molecular clonality of ipsilateral breast failures as they relate to outcome.