TY - JOUR
T1 - Perioperative measures to optimize margin clearance in breast conserving surgery
AU - Angarita, Fernando A.
AU - Nadler, Ashlie
AU - Zerhouni, Siham
AU - Escallon, Jaime
PY - 2014/6
Y1 - 2014/6
N2 - Margin status is one of the most important determinants of local recurrence following breast conserving surgery. The fact that up to 60% of patients undergoing breast conserving surgery require re-excision highlights the importance of optimizing margin clearance. In this review we summarize the following perioperative measures that aim to enhance margin clearance: (1) patient risk stratification, specifically risk factors and nomograms, (2) preoperative imaging, (3) intraoperative techniques including wire-guided localization, radioguided surgery, intraoperative ultrasound-guided resection, intraoperative specimen radiography, standardized cavity shaving, and ink-directed focal re-excision; (4) and intraoperative pathology assessment techniques, namely frozen section analysis and imprint cytology. Novel surgical techniques as well as emerging technologies are also reviewed. Effective treatment requires accurate preoperative planning, developing and implementing a consistent definition of margin clearance, and using tools that provide detailed real-time intraoperative information on margin status.
AB - Margin status is one of the most important determinants of local recurrence following breast conserving surgery. The fact that up to 60% of patients undergoing breast conserving surgery require re-excision highlights the importance of optimizing margin clearance. In this review we summarize the following perioperative measures that aim to enhance margin clearance: (1) patient risk stratification, specifically risk factors and nomograms, (2) preoperative imaging, (3) intraoperative techniques including wire-guided localization, radioguided surgery, intraoperative ultrasound-guided resection, intraoperative specimen radiography, standardized cavity shaving, and ink-directed focal re-excision; (4) and intraoperative pathology assessment techniques, namely frozen section analysis and imprint cytology. Novel surgical techniques as well as emerging technologies are also reviewed. Effective treatment requires accurate preoperative planning, developing and implementing a consistent definition of margin clearance, and using tools that provide detailed real-time intraoperative information on margin status.
KW - Breast cancer
KW - Breast conserving surgery
KW - Ductal carcinoma in situ
KW - Invasive ductal carcinoma
KW - Margin
KW - Margin clearance
KW - Margin status
KW - Perioperative tools
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U2 - 10.1016/j.suronc.2014.03.002
DO - 10.1016/j.suronc.2014.03.002
M3 - Review article
C2 - 24721660
AN - SCOPUS:84901670141
VL - 23
SP - 81
EP - 91
JO - Surgical Oncology
JF - Surgical Oncology
SN - 0960-7404
IS - 2
ER -