Width of excision margins after breast conserving surgery for invasive breast cancer and distant recurrence and survival

Importance of tumour removalIn many cancers, such as colorectal cancer, attention to ensuring meticulous removal of the cancer with an encompassing cuff of normal tissue (ie, no tumour at the pathological margin) results in improved outcomes. The association between margin involvement and poorer recurrence and survival outcomes12 led to studies that showed a strong association between the width of tumour from the margin in colorectal cancer and subsequent outcomes.2Most patients with early breast cancer are treated with breast conserving surgery. Removing cancers without leaving malignant cells at a surgical margin reduces local recurrence34567 but the effects of margin involvement on distant recurrence and mortality are unclear. How far the tumour should be from the specimen margin to ensure optimum oncological outcomes is contentious.The definition of a clear margin mattersWhen cancer is surgically removed, the tumour is subject to pathological examination. The edges of the removed cancer specimens, known as the…
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