Effect of cavity margin shavings to ensure completeness of excision on local recurrence rates following breast conserving surgery

• Published in: European journal of surgical oncology Vol. 29; no. 8; pp. 644 - 648
• Main Authors: Barthelmes, L, Al Awa, A, Crawford, D.J
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01.10.2003; Elsevier
• Subjects: Biological and medical sciences; Breast Neoplasms - pathology; Breast Neoplasms - surgery; cavity margin shavings; excision; Female; Gynecology. Andrology. Obstetrics; Humans; local recurrence rate; Mammary gland diseases; Mastectomy, Segmental - methods; Mastectomy, Segmental - standards; Medical Records; Medical sciences; Middle Aged; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - surgery; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the genital tract and mammary gland; Treatment Outcome; Tumors; excision; cavity margin shavings; local recurrence rate; Human; Cavity margin shavings; Treatment efficiency; Surgical resection; Malignant tumor; Mammary gland diseases; Anatomic pathology; Sensitivity; Conservative surgery; Shaving; Cavity; Cohort study; Female; Mammary gland; Technique
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1016/S0748-7983(03)00122-7

Aims: The presence of residual disease at the excision margin after breast conserving surgery is the most important risk factor for local recurrence. One method for assessing tumour margin involvement is to take shavings from the wall of the resulting cavity following wide excision of the lesion. Methods: We have reviewed our experience of shaving the margin of the cavity as our method to ensure completeness of excision. Results: Of 351 patients treated with breast conservation 61 patients had residual disease in the cavity margin biopsies. Younger age, axillary lymph node status, multi-focal tumours and high grade tumours were significantly correlated with margin involvement. In patients who had clear margins eight patients (2.8%) had developed a local recurrence at follow-up of 55 months (25–89 months). Conclusions: In our hands the use of cavity margin shavings allows us to achieve an acceptable rate of local control.