Your browser doesn't support javascript.
loading
Revisiting surgical margins for invasive breast cancer patients treated with breast conservation therapy - Evidence for adopting a 1 mm negative width.
Rakha, Emad A; Quinn, Cecily; Masannat, Yazan A; Lee, AndrewH S; Tan, Puay Hoon; Karakatsanis, Andreas; Matrai, Zoltan Tamas; Al Shaibani, Salman Husain M; Gehani, Salahddin A; Shaaban, Abeer; Khout, Hazem; Chagla, Leena; Cserni, Gábor; Varga, Zsuzsanna; Yong, Wong Fuh; Meattini, Icro; Kulka, Janina; Yang, Wentao; Tse, Gary M; Pinder, Sarah E; Fox, Stephen; Dixon, J Michael.
Afiliación
  • Rakha EA; Academic Unit for Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK; Pathology Department, Nottingham University Hospitals NHS Trust, Nottingham, UK; Department of Pathology, Hamad Medical Corporation, Doha, Qatar. Electronic address: emad.rakha@nottingham.
  • Quinn C; Irish National Breast Screening Programme and Department of Histopathology, St. Vincent's University Hospital, and School of Medicine, University College, Dublin, Ireland.
  • Masannat YA; Broomfield Breast Unit, Broomfield Hospital, Mid & South Essex NHS Trust, Chelmsford, CM1 7ET, England, UK; The London Breast Institute at Princess Grace Hospital, 42-52 Nottingham Place, London, W1U 5NY, England, UK.
  • Lee AS; Pathology Department, Nottingham University Hospitals NHS Trust, Nottingham, UK.
  • Tan PH; Luma Medical Centre, Royal Square Medical Centre, Singapore, Singapore.
  • Karakatsanis A; Department of Surgical Sciences, Faculty of Medicine, Uppsala University, Sweden.
  • Matrai ZT; Surgical Department Breast Oncoplastic Unit, Hamad Medical Corporation, Doha, Qatar.
  • Al Shaibani SHM; Surgical Department Breast Oncoplastic Unit, Hamad Medical Corporation, Doha, Qatar.
  • Gehani SA; Surgical Department Breast Oncoplastic Unit, Hamad Medical Corporation, Doha, Qatar.
  • Shaaban A; Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK; Cellular Pathology, Queen Elizabeth Hospital Birmingham, Birmingham, UK.
  • Khout H; Department of Breast Surgery, Nottingham University Hospitals NHS Trust, Nottingham, UK.
  • Chagla L; Breast Services, Mersey and West Lancashire Teaching Hospitals NHS Trust, UK.
  • Cserni G; Bács-Kiskun County Teaching Hospital, Department of Pathology, Kecskemét, Hungary. University of Szeged, Albert Szent-Györgyi Faculty of Medicine, Szeged, Hungary.
  • Varga Z; Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland.
  • Yong WF; Division of Oncology, Singapore General Hospital, Singapore, Singapore.
  • Meattini I; Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Florence, Italy; Radiation Oncology Unit, Breast Unit, Oncology Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
  • Kulka J; Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Budapest, Hungary.
  • Yang W; Shanghai Cancer Center, Shanghai, China.
  • Tse GM; Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Pinder SE; Guy's and St Thomas Hospitals/King's College London, London, UK.
  • Fox S; Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Australia.
  • Dixon JM; Edinburgh Breast Unit, and Edinburgh University and Western General Hospital Edinburgh, UK.
Eur J Surg Oncol ; 50(10): 108573, 2024 Oct.
Article en En | MEDLINE | ID: mdl-39243583
ABSTRACT
Clinical trials have demonstrated conclusively the non-inferiority of breast-conserving surgery followed by breast radiation therapy (BCT) compared with mastectomy for the treatment of early-stage invasive breast cancer (BC). The definition of the required surgical margin to ensure adequate removal of the cancer by BCT to obtain an acceptable low local recurrence (LR) rate remains controversial. Meta-analyses published by Houssami et al. in 2010 and 2014 demonstrated significantly lower LR rates for patients with a negative margin compared with those with positive (ink on tumour) or close (defined as ≤1 mm or ≤2 mm) margins. Neither meta-analysis addressed whether 'no ink on tumour' was adequate to define a negative margin because of a lack of data. Nevertheless, in 2014, the Society of Surgical Oncology (SSO) and the American Society for Radiation Oncology (ASTRO) with advice from pathologists reviewed these data together and published guidelines recommending that a margin of 'no ink on tumour' was sufficient to define a clear margin in BCT. Subsequently, clinical practice has varied with some national and international bodies endorsing 'no ink on tumour', whilst others have recommended a ≥1 mm margin as acceptable margins for BCT. A more recent meta-analysis conducted by Bundred and colleagues in 2022 did have sufficient data to compare 'no ink on tumour' and 1 mm and concluded that 1 mm rather than 'no ink on tumour', should be used as a minimum negative margin, and recommended that international guidelines be revised. The current review presents a balanced assessment of the evidence relating margin width and local recurrence after BCT. This review concludes that guidelines should consider re-defining a negative margin as ≥1 mm rather than 'no ink on tumour' in the context of BCT, recognising there will be variation to tailor therapy for any individual patient situation to ensure optimal patient care.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Mama / Mastectomía Segmentaria / Márgenes de Escisión / Recurrencia Local de Neoplasia Límite: Female / Humans Idioma: En Revista: Eur J Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Mama / Mastectomía Segmentaria / Márgenes de Escisión / Recurrencia Local de Neoplasia Límite: Female / Humans Idioma: En Revista: Eur J Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido