Optimal Margin Width in Breast Conservation Therapy: a Review of the Current Guidelines and Literature

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• 作者：Ava Hosseini (1)
  Bindupriya Chandrasekaran (1)
  Rebecca Aft (2)
  Sarah Blair (1) (3)
  
  1. Department of Surgery ; University of California鈥擲an Diego ; 200 West Arbor Drive #8220 ; San Diego ; CA ; 92103 ; USA
  2. Department of Surgery ; Washington University ; 660 South Euclid Avenue ; St. Louis ; MO ; 63110 ; USA
  3. UCSD Moores Cancer Center ; 3855 Health Sciences Drive MC 0987 ; La Jolla ; San Diego ; CA ; 92093 ; USA
  
• 关键词：Breast conservation therapy ; Margin width ; Ipsilateral breast tumor recurrence ; Margin re ; excision
• 刊名：Current Breast Cancer Reports
• 出版年：2015
• 出版时间：March 2015
• 年：2015
• 卷：7
• 期：1
• 页码：48-52
• 全文大小：118 KB
• 参考文献：1. Darby, S, McGale, P (2011) Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet 378: pp. 1707-16 36(11)61629-2" target="_blank" title="It opens in new window">CrossRef
  2. Fisher, B, Redmond, C, Poisson, R (1989) Eight-year results of a randomized clinical trial comparing total mastectomy and lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med 320: pp. 822-8 3303201302" target="_blank" title="It opens in new window">CrossRef
  3. Winchester, DP, Cox, JD (1998) Standards for diagnosis and management of invasive breast carcinoma. American College of Radiology. American College of Surgeons College of American Pathologists Society of Surgical Oncology. CA Cancer J. Clin 48: pp. 83-107 3322/canjclin.48.2.83" target="_blank" title="It opens in new window">CrossRef
  4. Litiere, S, Werutsky, G, Fentiman, IS (2012) Breast conserving therapy versus mastectomy for stage I鈥揑I breast cancer: 20聽year follow-up of the EORTC 10801 phase 3 randomised trial. Lancet Oncol 13: pp. 412-9 CrossRef
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  8. Houssami, N, Macaskill, P, Marinovich, ML, Morrow, M (2014) The association of surgical margins and local recurrence in women with early-stage invasive breast cancer treated with breast-conserving therapy: a meta-analysis. Ann Surg Oncol 21: pp. 717-30 34-014-3480-5" target="_blank" title="It opens in new window">CrossRef
  9. Moran, MS, Schnitt, SJ, Giuliano, AE (2014) Society of Surgical Oncology-American Society for Radiation Oncology consensus guideline on margins for breast-conserving surgery with whole-breast irradiation in stages I and II invasive breast cancer. J Clin Oncol Off J Am Soc Clin Oncol 32: pp. 1507-15 3.53.3935" target="_blank" title="It opens in new window">CrossRef
  10. Buchholz, TA, Somerfield, MR, Griggs, JJ (2014) Margins for breast-conserving surgery with whole-breast irradiation in stage I and II invasive breast cancer: American Society of Clinical Oncology endorsement of the Society of Surgical Oncology/American Society for Radiation Oncology consensus guideline. J Clin Oncol Off J Am Soc Clin Oncol 32: pp. 1502-6 CrossRef
  11. Jagsi, R, Smith, BD, Sabel, M, Pierce, L (2014) Individualized, patient-centered application of consensus guidelines to improve the quality of breast cancer care. Int J Radiat Oncol Biol Phys 88: pp. 535-6 3.11.236" target="_blank" title="It opens in new window">CrossRef
  12. Hunt, KK, Sahin, AA (2014) Too much, too little, or just right? Tumor margins in women undergoing breast-conserving surgery. J Clin Oncol Off J Am Soc Clin Oncol 32: pp. 1401-6 3.54.8388" target="_blank" title="It opens in new window">CrossRef
  13. Dunne, C, Burke, JP, Morrow, M, Kell, MR (2009) Effect of margin status on local recurrence after breast conservation and radiation therapy for ductal carcinoma in situ. J Clin Oncol Off J Am Soc Clin Oncol 27: pp. 1615-20 CrossRef
  14. Wang, SY, Chu, H, Shamliyan, T (2012) Network meta-analysis of margin threshold for women with ductal carcinoma in situ. J Natl Cancer Inst 104: pp. 507-16 3/jnci/djs142" target="_blank" title="It opens in new window">CrossRef
  
• 刊物主题：Oncology; Internal Medicine; Surgical Oncology;
• 出版者：Springer US
• ISSN：1943-4596

文摘

Randomized trials have clearly established breast conservation therapy (BCT) as appropriate treatment for early-stage invasive breast cancer. Current evidence shows that positive margins confer a greater than twofold risk of ipsilateral breast tumor recurrence. Thus, patients who have positive margins after BCT warrant re-excision. With regard to negative margins, however, the optimal negative margin width remains unclear. This article reviews the recent guidelines set forth by the Society of Surgical Oncology and the American Society of Radiation Oncology regarding the margin width in stage I and II invasive breast cancer. We also discuss the controversies related to implementation of these guidelines.