title: Volume of excision and cosmesis with routine cavity shave margins technique.
abstract: BACKGROUND
  Cavity shave margin (CSM) removal is a surgical technique that reduces re-excision rates. One criticism of this technique has been that negative margins are obtained primarily as a result of higher volumes of tissue removed. This study evaluates the volume of tissue removed in a group that underwent CSM versus one that underwent standard partial mastectomy (SPM) and explores cosmetic outcomes.
  
  
  METHODS
  Single-institution retrospective review identified 533 patients with a diagnosis of breast cancer who underwent PM. Matched pair analysis of 72 patients who had undergone PM with CSM versus 72 who had undergone SPM was performed. Volumes were calculated from dimensions in the pathology report. A subgroup was analyzed by a multidisciplinary panel for cosmetic outcome using the Harvard Breast Cosmesis Grading Scale.
  
  
  RESULTS
  Mean tumor size in the CSM group was 1.52 versus 1.51 cm(3) in the SPM (P = 0.8073). Mean total volume of tissue excised with CSM was lower than that in the SPM group. Mean volume of excision with CSM was 80.66 and 165.1 cm(3) in the SPM group (P = 0.0005). Patients undergoing CSM required fewer re-excisions than the SPM group: 13 (18.1%) versus 25 (34.6%) (P = 0.03). Mean score for cosmesis was 2.3 in the CSM group and 3.0 for SPM (P = 0.0004).
  
  
  CONCLUSIONS
  CSM decreases the need for re-excision. Total tissue volume excised is lower in patients who undergo CSM, and cosmetic results appear to be improved. This approach should be considered for all patients undergoing PM.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Mook
authors.forename: Rebecca
authors.initials: R
authors.lastname: Klein
authors.forename: Anne
authors.initials: A
authors.lastname: Kobbermann
authors.forename: Alison
authors.initials: A
authors.lastname: Unzeitig
authors.forename: David
authors.initials: D
authors.lastname: Euhus
authors.forename: Yan
authors.initials: Y
authors.lastname: Peng
authors.forename: Venetia
authors.initials: V
authors.lastname: Sarode
authors.forename: Amy
authors.initials: A
authors.lastname: Moldrem
authors.forename: A Marilyn
authors.initials: AM
authors.lastname: Leitch
authors.forename: Valerie
authors.initials: V
authors.lastname: Andrews
authors.forename: Sumeet
authors.initials: S
authors.lastname: Teotia
authors.forename: Roshni
authors.initials: R
authors.lastname: Rao
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D004954:Esthetics; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged