Perioperative measures to optimize margin clearance in breast conserving surgery

Area of Science:

• Oncology
• Surgical Oncology
• Breast Surgery

Background:

• Local recurrence after breast conserving surgery (BCS) is significantly influenced by margin status.
• Up to 60% of patients undergoing BCS require re-excision due to inadequate margin clearance, underscoring the need for improved techniques.

Purpose of the Study:

• To review perioperative measures aimed at enhancing margin clearance during breast conserving surgery.
• To highlight novel surgical techniques and emerging technologies for optimizing surgical margins.

Main Methods:

• Review of perioperative strategies including patient risk stratification (risk factors, nomograms), preoperative imaging, and intraoperative techniques.
• Evaluation of intraoperative pathology assessment methods such as frozen section analysis and imprint cytology.
• Discussion of novel surgical techniques and emerging technologies for margin assessment.

Main Results:

• Various perioperative measures can enhance margin clearance in BCS.
• Intraoperative techniques like specimen radiography and cavity shaving are key.
• Real-time intraoperative information on margin status is vital for effective treatment.

Conclusions:

• Accurate preoperative planning and a consistent definition of margin clearance are essential.
• Implementing tools for real-time intraoperative margin assessment improves outcomes.
• Optimizing margin clearance reduces the need for re-excision and local recurrence rates.