Surgical Margins in Breast Cancer: Finally Defined?.

ABSTRACT

It is proven that breast conservative surgery plus radiotherapy is safe and has equivalent results when compared to mastectomy. It is known that positive surgical margins increase the risk of local recurrence. The effect of increasing negative margin width after breast-conserving therapy on local recurrence is controversial. There is no consensus on what constitutes adequate negative margins in breast conservative surgery. There is also an evident association between widely negative margins and excessive breast tissue ressection, with poor cosmetic outcomes. Besides, reexcisions represent elevated costs and psychological trauma to the patients. Definition of what constitutes an adequate margin for both invasive and noninvasive breast cancer is clearly needed. We review here the evolution of surgical margins concepts in breast cancer and try to establish the ideal and current surgical approach for each patient.