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The relationship between shaved margin and inked margin status in breast excision specimens
A J Guidi1, J L Connolly, J R Harris
1Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215, USA.
Cancer
|April 15, 1997
Summary
Shaved margins (SMs) may not accurately reflect inked margins (IMs) in breast cancer. A positive SM is less likely to indicate a positive IM, especially when tumor extent is minimal.
Area of Science:
- Oncology
- Surgical Pathology
- Breast Cancer Research
Background:
- Tumor at inked margins (IMs) increases local recurrence risk after breast-conserving therapy.
- Shaved margins (SMs) are proposed for more thorough margin assessment.
- Comparison of IM and SM assessment accuracy is lacking.
Purpose of the Study:
- To compare the accuracy of shaved margins (SMs) versus inked margins (IMs) in detecting residual breast cancer.
- To determine if SM assessment provides comparable information to IM assessment.
Main Methods:
- 22 breast reexcision specimens with positive SMs were analyzed.
- 199 SMs were examined histologically.
- Tumor presence and extent in SMs were compared to IM status.
Main Results:
- All specimens had at least one positive SM, but only 55% had positive IMs.
- 61% of positive SMs corresponded to a positive IM.
- Positive IM likelihood increased with SM tumor extent (19% for 1 field, 97% for ≥3 fields).
Conclusions:
- Positive SMs do not always indicate positive IMs.
- A positive IM is more reliably predicted by extensive tumor involvement on SMs (≥3 fields).
- Clinical implications of positive SMs may differ from positive IMs; outcome studies are needed.