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Related Experiment Video

Updated: Jan 25, 2026

Single-Port Robotic-assisted Transaxillary Breast-conserving Surgery: A Prospective, Single-arm, Non-randomized Phase IIa Clinical Trial
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Polygon method: A systematic margin assessment for breast conservation.

Shu Ichihara1, Suzuko Moritani2, Rieko Nishimura1

  • 1National Hospital Organization Nagoya Medical Center, Nagoya, Japan.

Cancer Medicine
|May 8, 2019
PubMed
Summary
This summary is machine-generated.

The polygon method can identify ductal carcinoma in situ (DCIS) patients who may safely avoid radiation therapy (RT) after breast-conserving surgery (BCS). A negative margin by this method indicates a low risk of recurrence, suggesting RT may be unnecessary for this subset.

Keywords:
contralateral breast canceripsilateral local recurrencenew primarypancake phenomenontrue recurrence

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Area of Science:

  • Oncology
  • Surgical Pathology
  • Radiotherapy

Background:

  • Radiation therapy (RT) following breast-conserving surgery (BCS) for ductal carcinoma in situ (DCIS) may represent overtreatment for some patients.
  • A subset of DCIS patients with eradicated disease and low ipsilateral breast tumor recurrence (IBTR) risk, approaching contralateral breast cancer (CBC) levels, may not benefit from RT.

Purpose of the Study:

  • To evaluate the polygon method, a novel en face margin assessment technique, for identifying DCIS patients who can be safely treated with BCS alone.
  • To determine if the polygon method can identify a subset of DCIS patients for whom RT is not beneficial.

Main Methods:

  • The polygon method utilizes an adjustable mold to preserve breast tissue shape, preventing flattening and allowing comprehensive en face margin visualization.
  • This preanalytical technique provides a panoramic view of margins 3-5 mm deep from the cut surfaces.
  • Competing risk analysis was employed to quantify IBTR and CBC rates and identify risk factors.

Main Results:

  • Among 100 DCIS patients with negative margins by the polygon method, 5 experienced IBTR (3 DCIS, 2 invasive ductal carcinoma [IDC]) and 10 experienced CBC (6 DCIS, 4 IDC) over a median follow-up of 7.6 years.
  • Five- and 10-year cumulative incidence rates were 3.0% and 5.3% for IBTR, and 7.1% and 13.3% for CBC, respectively.
  • Patients with negative margins demonstrated a twofold lower IBTR risk compared to CBC, even without RT.

Conclusions:

  • Japanese women with DCIS and negative margins, as determined by the polygon method, exhibit a very low IBTR risk.
  • This subset of patients accounts for approximately half of CBC cases, suggesting that additional RT may not be beneficial for them.