Impact of Margin Assessment Method on Positive Margin Rate and Total Volume Excised

Background For breast-conserving surgery, the method of margin assessment that most frequently achieves negative margins without increasing the volume of tissue excised is uncertain. We examined our institutional experience with three different margin assessment methods used by six experienced breas...

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Bibliographic Details
Published in:Annals of surgical oncology 2014-01, Vol.21 (1), p.86-92
Main Authors: Moo, Tracy-Ann, Choi, Lydia, Culpepper, Candice, Olcese, Cristina, Heerdt, Alexandra, Sclafani, Lisa, King, Tari A., Reiner, Anne S., Patil, Sujata, Brogi, Edi, Morrow, Monica, Van Zee, Kimberly J.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Breast Neoplasms - pathology
Breast Neoplasms - surgery
Breast Oncology
Carcinoma, Ductal, Breast - pathology
Carcinoma, Ductal, Breast - surgery
Female
Follow-Up Studies
Humans
Mastectomy, Segmental
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Neoplasm, Residual - pathology
Neoplasm, Residual - surgery
Oncology
Prognosis
Prospective Studies
Retrospective Studies
Surgery
Surgical Oncology
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Summary:Background For breast-conserving surgery, the method of margin assessment that most frequently achieves negative margins without increasing the volume of tissue excised is uncertain. We examined our institutional experience with three different margin assessment methods used by six experienced breast surgeons. Methods Patients undergoing breast-conserving surgery for invasive carcinoma during July to December of a representative year during which each method was performed (perpendicular, 2003; tangential, 2004; cavity shave, 2011) were included. The effect of margin method on the positive margin rate at first excision and the total volume excised to achieve negative margins were evaluated by multivariable analysis, by surgeon, and by tumor size and presence of extensive intraductal component (EIC). Results A total of 555 patients were identified, as follows: perpendicular, 140; tangential, 124; and cavity shave, 291. The tangential method had a higher rate of positive margins at first excision than the perpendicular and cavity-shave methods (49, 15, 11 %, respectively; p  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-013-3257-2