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Minerva Chirurgica 2012 October;67(5):445-52

Copyright © 2012 EDIZIONI MINERVA MEDICA

language: English

Surgical margins of resection for breast cancer: current evidence

Amato B. 1, Rispoli C. 2, Iannone L. 1, Testa S. 1, Compagna R. 1, Rocco N. 1

1 Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, Federico II University, Naples, Italy; 2 Department of General and Emergency Surgery, Local Health Unit Napoli1, Naples, Italy


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Breast cancer is the most common form of cancer and second main cause of death in women in western countries. Breast-conserving therapy, consisting of lumpectomy and radiation therapy, has become the standard local treatment for T1-T2 breast tumors. There is general agreement that successful breast conservation requires complete tumor excision with a “tumor-free” or “negative” margin of resection, but the definition of a negative margin is controversial. A commonly accepted definition of adequate margins requires a 2-mm distance between ink and tumor but opinions range from the original National Surgical Adjuvant Breast and Bowel Project definition of “no ink on tumor”, to a recommended width of 10 mm or more. The ability to perform real-time molecular imaging analysis of margins during surgery would clearly be a significant advance; several groups have engaged in this effort, with encouraging reports of preliminary data. Further development of such techniques promises to lead to a point at which accurate intraoperative margin evaluation may be possible and may even be combined with therapeutic interventions, using techniques such as photodynamic therapy.

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