Surgical margins in breast conservation therapy: how much should we excise?

Abstract

Background: Breast conservation therapy (BCT) has become the standard of treatment for early stage breast cancer, and the surgical margin was one of the important factors that affected risk of local recurrence. This review looks at the safe margin for BCT in early stage invasive breast cancer and ductal carcinoma in situ (DCIS).

Methods: Published literature abstracted in Medline was searched using the gateway site from the US National Library of Medicine.

Conclusions: A positive margin is associated with increased risk of local recurrence after BCT for invasive breast cancer and DCIS. However there was no cut off for the margin width and the significance of a close margin remains controversial. It was generally accepted that the risk of local recurrence was low if the margin was >or=10 mm while margins that were <2 mm were considered inadequate. The surgeon needs to balance the risk between local recurrence and cosmesis in planning BCT so that the prognosis is not compromised.