Two millimeters removed around tumors prevents residual disease in breast cancer patients

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Surgeons who remove two millimeters around breast cancer tumors may eliminate chances of residual disease, according to a study published in the International Journal of Clinical Practice (2010 Nov;64(12):1675-80).

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.”

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