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Optimizing Surgical Margins in Breast Conservation

Adequate surgical margins in breast-conserving surgery for breast cancer have traditionally been viewed as a predictor of local recurrence rates. There is still no consensus on what constitutes an adequate surgical margin, however it is clear that there is a trade-off between widely clear margins an...

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Autores principales: Ananthakrishnan, Preya, Balci, Fatih Levent, Crowe, Joseph P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3523540/
https://www.ncbi.nlm.nih.gov/pubmed/23304479
http://dx.doi.org/10.1155/2012/585670
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author Ananthakrishnan, Preya
Balci, Fatih Levent
Crowe, Joseph P.
author_facet Ananthakrishnan, Preya
Balci, Fatih Levent
Crowe, Joseph P.
author_sort Ananthakrishnan, Preya
collection PubMed
description Adequate surgical margins in breast-conserving surgery for breast cancer have traditionally been viewed as a predictor of local recurrence rates. There is still no consensus on what constitutes an adequate surgical margin, however it is clear that there is a trade-off between widely clear margins and acceptable cosmesis. Preoperative approaches to plan extent of resection with appropriate margins (in the setting of surgery first as well as after neoadjuvant chemotherapy,) include mammography, US, and MRI. Improvements have been made in preoperative lesion localization strategies for surgery, as well as intraoperative specimen assessment, in order to ensure complete removal of imaging findings and facilitate margin clearance. Intraoperative strategies to accurately assess tumor and cavity margins include cavity shave techniques, as well as novel technologies for margin probes. Ablative techniques, including radiofrequency ablation as well as intraoperative radiation, may be used to extend tumor-free margins without resecting additional tissue. Oncoplastic techniques allow for wider resections while maintaining cosmesis and have acceptable local recurrence rates, however often involve surgery on the contralateral breast. As systemic therapy for breast cancer continues to improve, it is unclear what the importance of surgical margins on local control rates will be in the future.
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spelling pubmed-35235402013-01-09 Optimizing Surgical Margins in Breast Conservation Ananthakrishnan, Preya Balci, Fatih Levent Crowe, Joseph P. Int J Surg Oncol Review Article Adequate surgical margins in breast-conserving surgery for breast cancer have traditionally been viewed as a predictor of local recurrence rates. There is still no consensus on what constitutes an adequate surgical margin, however it is clear that there is a trade-off between widely clear margins and acceptable cosmesis. Preoperative approaches to plan extent of resection with appropriate margins (in the setting of surgery first as well as after neoadjuvant chemotherapy,) include mammography, US, and MRI. Improvements have been made in preoperative lesion localization strategies for surgery, as well as intraoperative specimen assessment, in order to ensure complete removal of imaging findings and facilitate margin clearance. Intraoperative strategies to accurately assess tumor and cavity margins include cavity shave techniques, as well as novel technologies for margin probes. Ablative techniques, including radiofrequency ablation as well as intraoperative radiation, may be used to extend tumor-free margins without resecting additional tissue. Oncoplastic techniques allow for wider resections while maintaining cosmesis and have acceptable local recurrence rates, however often involve surgery on the contralateral breast. As systemic therapy for breast cancer continues to improve, it is unclear what the importance of surgical margins on local control rates will be in the future. Hindawi Publishing Corporation 2012 2012-12-09 /pmc/articles/PMC3523540/ /pubmed/23304479 http://dx.doi.org/10.1155/2012/585670 Text en Copyright © 2012 Preya Ananthakrishnan et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Ananthakrishnan, Preya
Balci, Fatih Levent
Crowe, Joseph P.
Optimizing Surgical Margins in Breast Conservation
title Optimizing Surgical Margins in Breast Conservation
title_full Optimizing Surgical Margins in Breast Conservation
title_fullStr Optimizing Surgical Margins in Breast Conservation
title_full_unstemmed Optimizing Surgical Margins in Breast Conservation
title_short Optimizing Surgical Margins in Breast Conservation
title_sort optimizing surgical margins in breast conservation
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3523540/
https://www.ncbi.nlm.nih.gov/pubmed/23304479
http://dx.doi.org/10.1155/2012/585670
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