期刊
JOURNAL OF CLINICAL ONCOLOGY
卷 34, 期 33, 页码 4040-U166出版社
AMER SOC CLINICAL ONCOLOGY
DOI: 10.1200/JCO.2016.68.3573
关键词
-
类别
资金
- Susan G. Komen
- National Breast Cancer Foundation (NBCF
- NBCF Australia) Breast Cancer Research Leadership Fellowship
- Cancer Institute New South Wales Fellowship
- National Breast Cancer Foundation [LF-16-001] Funding Source: researchfish
Background Controversy exists regarding the optimal negative margin width for ductal carcinoma in situ (DCIS) treated with breast-conserving surgery and whole-breast irradiation (WBRT). Methods A multidisciplinary consensus panel used a meta-analysis of margin width and ipsilateral breast tumor recurrence (IBTR) from a systematic review of 20 studies including 7883 patients and other published literature as the evidence base for consensus. Results Negative margins halve the risk of IBTR compared with positive margins defined as ink on DCIS. A 2 mm margin minimizes the risk of IBTR compared with smaller negative margins. More widely clear margins do not significantly decrease IBTR compared with 2 mm margins. Negative margins less than 2 mm alone are not an indication for mastectomy, and factors known to impact rates of IBTR should be considered in determining the need for re-excision. Conclusion The use of a 2 mm margin as the standard for an adequate margin in DCIS treated with WBRT is associated with low rates of IBTR and has the potential to decrease re-excision rates, improve cosmetic outcome, and decrease health care costs. Clinical judgment should be used in determining the need for further surgery in patients with negative margins < 2 mm. (C) 2016 American Society of Clinical Oncology, Society of Surgical Oncology, and American Society for Radiation Oncology
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据