Surgical Resection Margins after Breast-Conserving Surgery: Senonetwork Recommendations

This paper reports findings of the “Focus on Controversial Areas” Working Party of the Italian Senonetwork, which was set up to improve the care of breast cancer patients. After reviewing articles in English on the MEDLINE system on breast conserving surgery for invasive carcinoma, the Working Party...

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Bibliographic Details
Published in:Tumori 2016-05, Vol.102 (3), p.284-289
Main Authors: Galimberti, Viviana, Taffurelli, Mario, Leonardi, Maria Cristina, Aristei, Cynthia, Trentin, Chiara, Cassano, Enrico, Pietribiasi, Francesca, Corso, Giovanni, Munzone, Elisabetta, Tondini, Carlo, Frigerio, Alfonso, Cataliotti, Luigi, Santini, Donatella
Format: Article
Language:English
Subjects:
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Breast Neoplasms - diagnostic imaging
Breast Neoplasms - pathology
Breast Neoplasms - surgery
Chemotherapy, Adjuvant
Evidence-Based Medicine
Female
Humans
Italy
Magnetic Resonance Imaging
Mammography
Margins of Excision
Mastectomy, Segmental - standards
Mastectomy, Segmental - trends
Middle Aged
Neoadjuvant Therapy
Radiotherapy, Adjuvant
Reoperation
Time Factors
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Summary:This paper reports findings of the “Focus on Controversial Areas” Working Party of the Italian Senonetwork, which was set up to improve the care of breast cancer patients. After reviewing articles in English on the MEDLINE system on breast conserving surgery for invasive carcinoma, the Working Party presents their recommendations for identifying risk factors for positive margins, suggests how to manage them so as to achieve the highest possible percentage of negative margins, and proposes standards for investigating resection margins and therapeutic approaches according to margin status. When margins are positive, approaches include re-excision, mastectomy, or, as second-line treatment, radiotherapy with a high boost dose. When margins are negative, boost administration and its dose depend on the risk of local recurrence, which is linked to biopathological tumor features and surgical margin width. Although margin status does not affect the choice of systemic therapy, it may delay the start of chemotherapy when further surgery is required.
ISSN:0300-8916
2038-2529
DOI:10.5301/tj.5000500