Routine shave margins are not necessary in early stage breast cancer treated with Breast Conserving Surgery

Am J Surg. 2018 May;215(5):922-925. doi: 10.1016/j.amjsurg.2017.12.020. Epub 2018 Jan 16.

Abstract

Introduction: Breast Conserving Surgery (BCS) is considered standard of care for women with early stage breast cancer. Between 20 and 50% of women treated with BCS will require re-operation for positive or close margins and it has been suggested that routine cavity shave margins may reduce the frequency of positive margins.

Methods: Retrospective chart review of a prospectively maintained surgical database of patients undergoing BCS for early stage breast cancer, at a single institution, between January 2012 and December 2015. Cohort was followed until June 2016 to capture re-operations.

Results: Among 2096 patients with stage 0-III breast cancers, 872 (42%) underwent primary mastectomies and 1224 (58%) underwent primary BCS. Margins were positive in 128 (11%) and close in 442 (36%). Re-operation rate for patients after BCS was 19%.

Conclusion: A lower than predicted positive margin rate suggests that routine shave margins are not warranted at our institution.

Keywords: Breast Conserving Surgery; Cavity shave margins.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / surgery*
  • British Columbia
  • Female
  • Humans
  • Margins of Excision*
  • Mastectomy, Segmental*
  • Middle Aged
  • Neoplasm, Residual / pathology
  • Reoperation / statistics & numerical data
  • Retrospective Studies