REVIEWS   

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

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.