Two millimeters removed around tumors prevents residual disease in breast cancer patients
Surgeons from the department of breast surgery at Good Hope Hospital, Sutton Coldfield, UK, conducted a study involving 303 women who had undergone breast-conserving surgery at the hospital between 2002 and 2008. The surgeons carried out excision specimens on 31% of the women who had received breast-conserving surgery to check for residual disease and identified 52 samples that were from patients who had received surgery for non-invasive cancer.The Good Hope team found that in the women who had received surgery for invasive cancer, the amount of residual disease reduced as the free margin increased, from 35.3% with no margin to 2.4% with a margin of 2 mm or greater. However, for women who had received surgery for non-invasive cancer, residual disease was higher. Specifically, incidence ranged from 0% at more than 5 mm to 57% when the margin was between 0.1 to 0.9 mm, but 44% when no margin was involved.
When the researchers looked at the characteristics of the 202 women who had a close free margin of less than 2 mm and the 101 women who had a clear free margin 2 mm or greater, they found that women with a close margin of less than 2 mm were more likely to be associated with large grade three tumors than the clear margin group.
“Our research found that the overall probability of finding residual disease was 2.4% if a woman had surgery where the free margin was 2 mm or greater from the invasive cancer. But the same pattern was not observed when the women had surgery for non-invasive cancer, where the incidence of residual disease was higher,” the authors concluded. “Based on these results, we feel confident that a free margin of 2 mm from the area of invasive cancer is adequate to minimize residual disease, but the equivalent free margin for non-invasive cancer remains unclear.”