Abstract
•Conservative breast surgery is the standard technique in breast cancer.•Multifocal breast cancer is a risk factor for involved margins.•Positive margins are considered one of the predictors for local recurrence.•Preoperative wire mapping after breast marking by the surgeon increase the chance to have negative margins.
Highlights
Mastectomy was the only type of surgery for the treatment of breast cancer, until the Milan trial in 1970
It is currently acknowledged that conservative breast surgery is the standard technique in early breast cancer and is broadly used in ductal carcinoma in situ (DCIS) and locally advanced breast cancer after neoadjuvant chemotherapy [2]
Negative margins are defined according to the Society of Surgical Oncology-American Society for Radiation Oncology (SSO-ASTRO) as “no ink on tumour” for invasive cancer, while 2 mm is enough in DCIS [4,5]
Summary
Mastectomy was the only type of surgery for the treatment of breast cancer, until the Milan trial in 1970. This trial introduced the concept of conservative breast surgery, for which many studies found a disease-free survival rate equivalent to that of mastectomy [1]. One of the main principles of conservative surgery is to achieve negative margins, as residual malignant tissue is associated with a higher rate of local recurrence (0.6%–1.5% per year) [3]. A positive margin is considered to be one of the main prognostic indicators of local recurrence in breast cancer surgery, with various factors related to the surgeon or to the tumour itself contributing to this [6]. Reexcision or even mastectomy is the only way to cure such cases
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