Sie sind bereits registriert?
Loggen Sie sich mit Ihrem Universimed-Benutzerkonto ein:
Sie sind noch nicht registriert?
Registrieren Sie sich jetzt kostenlos auf universimed.com und erhalten Sie Zugang zu allen Artikeln, bewerten Sie Inhalte und speichern Sie interessante Beiträge in Ihrem persönlichen Bereich
zum späteren Lesen. Ihre Registrierung ist für alle Unversimed-Portale gültig. (inkl. allgemeineplus.at & med-Diplom.at)
Resection of Cavity Shave Margins in Breast Conserving Surgery
The need to return to the operating room for positive margins after breast-conserving surgery delays adjuvant therapy, is upsetting to patients, and is expensive for individuals and health systems. Prior, single-center studies have shown that circumferential resection of additional tissue around the tumor cavity (cavity shave margin [CSM]) reduces the rate of positive margins and re-excision in breast cancer patients undergoing partial mastectomy (PM).
To further assess the benefit of CSM resection in this setting, investigators conducted a multicenter, randomized trial in which 400 stage 0–III breast cancer patients undergoing PM were assigned to either have CSM resection (shave group) or not have CSM resection (no shave group). Randomization occurred intraoperatively after completion of standard PM.
Prior to randomization, positive margin rates were similar in the shave and no-shave groups (38.8% and 36.0%, respectively). After randomization, positive margin rates were significantly lower in the shave group (9.7% vs. 36.0%; P<0.001), as were rates of additional surgery to obtain negative margins (8.7% vs. 23.5%; P<0.001). The median total volume of tissue excised was significantly higher in the shave group (101.1 cm3 vs. 73.4 cm3; P<0.001).
Comment
This important trial adds further compelling data to demonstrate that utilizing circumferential CSM resection after initial standard intraoperative selective excision significantly reduces the need to return to surgery for margin control. As expected, significantly more tissue was removed with CSM resection than without it. Ultimate final cosmetic outcomes in both groups will be reported at the 1- and 5-year marks.
Citation(s)
Author:
Dupont E et al.
Title:
Resection of cavity shave margins in stage 0–III breast cancer patients undergoing breast conserving surgery: A prospective multicenter randomized controlled trial.
Source:
Ann Surg
2019
Jul
8; [e-pub].
(Abstract/FREE Full Text)
Empfohlen von
Henry Mark Kuerer, MD, PhD, FACS