title: Surgical margins in breast conservation.
abstract: Breast cancer is the most common tumor affecting women worldwide. Breast-conserving therapy (BCT) followed by irradiation nowadays is the treatment of choice for early-stage disease; there is no difference in long-term survival between mastectomy and BCT combined with external radiotherapy. A positive margin is associated with increased risk of local recurrences after BCT for invasive breast cancer and ductal carcinoma in situ. The exact definition of an adequate surgical margin after breast cancer resection has long been debated among physicians and represents an area of considerable variation in clinical practice. There is a lack of standardization in the pathology methods of margin evaluation, which yields little consensus regarding what constitutes an adequate negative margin. As a consequence, patient management varies widely based on the threshold that surgeons accept for adequate margins and the subsequent need for re-excision. We analyze and discuss recent literature about this topic both from the pathological and from the surgical point of view.
authors.affiliation: Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy; Senology Research Center, University of Insubria, Varese, Italy.
authors.forename: Corrado
authors.initials: C
authors.lastname: Chiappa
authors.affiliation: Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy; Senology Research Center, University of Insubria, Varese, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Rovera
authors.affiliation: Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, USA.
authors.forename: Adriana Dionigi
authors.initials: AD
authors.lastname: Corben
authors.affiliation: Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy; Senology Research Center, University of Insubria, Varese, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Fachinetti
authors.affiliation: Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy; Senology Research Center, University of Insubria, Varese, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: De Berardinis
authors.affiliation: Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy; Senology Research Center, University of Insubria, Varese, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Marchionini
authors.affiliation: Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Rausei
authors.affiliation: Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Boni
authors.affiliation: Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy.
authors.forename: Gianlorenzo
authors.initials: G
authors.lastname: Dionigi
authors.affiliation: Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy.
authors.forename: Renzo
authors.initials: R
authors.lastname: Dionigi
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006652:Histological Techniques; D006801:Humans; D015412:Mastectomy, Segmental / Q000379:methods*
keywords: Breast conservative therapy; Breast surgery; Surgical margins