Surgical management modifications following systematic additional shaving of cavity margins in breast-conservation treatment

Ann Surg Oncol. 2011 Jan;18(1):114-8. doi: 10.1245/s10434-010-1211-0. Epub 2010 Jul 14.

Abstract

Background: Positive wide local excision margins are the most important risk factor of local breast-carcinoma recurrence. Shaving additional margins could lower the need for re-excisions when wide local excision margins are positive and cavity margins are negative.

Materials and methods: This retrospective study, from January 2007 to December 2008, included 99 women with breast carcinomas who underwent wide local excision with 4 additional, systematically shaved, surgical cavity margins. All therapeutic decisions concerning post-wide local excision treatment were made by consensus during multidisciplinary meetings.

Results: This systematic cavity-shaving strategy avoided 25 re-excisions (25.3%), and 6 patients required new surgery because of carcinoma found in the additional cavity-shaving margins, despite negative wide local excision margins. No preoperative factor predictive of positive cavity margins was identified.

Conclusions: Systematic shaving of additional cavity margins changed the surgical management after breast-conservation treatment.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery*
  • Carcinoma, Ductal, Breast / pathology
  • Carcinoma, Ductal, Breast / surgery*
  • Carcinoma, Lobular / pathology
  • Carcinoma, Lobular / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Mastectomy, Segmental*
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / surgery*
  • Prognosis
  • Retrospective Studies
  • Risk Management
  • Survival Rate