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Updated: May 30, 2025

Intraoperative Assessment of Resection Margins in Oral Cavity Cancer: This is the Way

Intraoperative Assessment of Resection Margins in Oral Cavity Cancer: This is the Way

Published on: May 10, 2021

Risk Factors for Positive Resection Margins Following Breast-Conserving Surgery.

Gabriella Truda¹, Sarah Howells², Madeleine Berry¹

¹Department of Breast, Plastic and Reconstructive Surgery, Royal Hallamshire Hospital, Sheffield, GBR.

|January 27, 2025

Summary

This summary is machine-generated.

The study found that ductal carcinoma in situ (DCIS) at the resection margin is a key factor for re-excision after breast conserving surgery (BCS). Imaging size discrepancies also impact outcomes, with mammography and ultrasound showing better correlation than MRI.

Keywords:

breast cancer pathology breast-cancer breast-conserving surgery ductal carcinoma in situ (dcis)margin re-excision non palpable breast cancer positive margins resection margins wle - wide local excision

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Area of Science:

Oncology
Radiology
Surgical Pathology

Background:

Margin re-excision is a critical quality measure for breast conserving surgery (BCS), with a target of less than 20% in the UK.
Despite extensive research, factors leading to margin involvement remain, contributing to a persistently high re-excision rate.
This study investigates adverse features compromising margin clearance in BCS for invasive breast carcinoma and ductal carcinoma in situ (DCIS).

Purpose of the Study:

To identify adverse pathological and radiological features associated with margin re-excision in BCS.
To evaluate the discrepancy between imaging-estimated and histopathological tumor size.
To analyze the effectiveness of re-excision in achieving clear margins.

Main Methods:

Retrospective analysis of 194 margin re-excisions following BCS for invasive breast carcinoma and DCIS (October 2013-September 2018).
Inclusion of radiological (mammogram, ultrasound, MRI) and histopathology data for each patient.
Analysis of lesion size, focality, tumor characteristics, and margin status post-re-excision.

Main Results:

Overall re-excision rate was 14.06%.
Ductal carcinoma in situ (DCIS) at the resection margin was the most consistent factor necessitating re-excision.
A significant discrepancy was observed between imaging and histopathological tumor size, with mammography and ultrasound showing better correlation than MRI.

Conclusions:

The presence of DCIS at the resection margin is the primary predictor for re-excision in BCS.
Discrepancies in tumor size measurement between imaging modalities and final pathology impact surgical planning and outcomes.
Mammography and ultrasound provide more accurate tumor size estimations compared to MRI in this cohort.