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Margins in breast conserving surgery: A practice-changing process.

I T Rubio1, M Ahmed2, T Kovacs3

  • 1Breast Surgical Oncology, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.

European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
|February 17, 2016
PubMed
Summary
This summary is machine-generated.

Achieving adequate margins in breast conserving surgery (BCS) remains debated, impacting re-excision rates and patient outcomes. Evolving surgical techniques and multimodal treatments are improving local recurrence rates in BCS.

Keywords:
Breast cancerBreast conserving surgeryMargins

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Breast Cancer Research

Background:

  • Defining adequate margins in breast conserving surgery (BCS) is a persistent challenge.
  • Inconsistent margin definitions lead to high re-excision rates (25-40%), affecting cosmesis, cost, and patient satisfaction.
  • Local recurrence (LR) risk is influenced by margin status, impacting patient survival.

Purpose of the Study:

  • To review the evolving landscape of margin assessment in BCS.
  • To highlight the impact of changing attitudes towards re-excision in breast cancer management.
  • To emphasize the integration of patient and treatment factors in margin evaluation.

Main Methods:

  • Review of current literature and consensus guidelines on surgical margins in BCS.
  • Analysis of trends in re-excision rates and their contributing factors.
  • Discussion of advancements in surgical techniques and adjuvant therapies impacting margin assessment.

Main Results:

  • Significant variability exists in defining adequate margins, contributing to high re-excision rates.
  • Improvements in surgical techniques and multimodal treatments have reduced local recurrence rates in BCS.
  • There is a discernible shift towards a more holistic approach in evaluating margins, considering patient and tumor characteristics alongside systemic treatments.

Conclusions:

  • The definition of adequate margins in BCS requires further consensus to optimize patient care.
  • Multimodal treatment strategies and improved surgical assessment are crucial in minimizing local recurrences.
  • Surgeons are increasingly adopting a personalized approach to margin management in breast cancer surgery.