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204584

Routine Margin Shaving Of Lumpectomy Cavity During Breast Conserving Surgery Detects Occult Multifocal Cancer, A Prospective Study

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Last updated: 03 Jan 2025

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Abstract

Background:  Cavity shaving (CS) entails circumferential tissue removal from residual lumpectomy cavity following tumor resection during breast conserving surgery (BCS). It could allow detection of occult multifocal breast cancer (OMFBC). Objectives: This study aimed to highlight the impact of unidentified OMFBC as essential risk factor for local recurrence after BCS.  Patients and Methods: Eligible breast cancer patients for BCS and CS were prospectively enrolled. Patients with negative margins of “resected tumor specimens" were designated as group A whereas group B comprised those with positive margins. OMFBC, diagnosed in the additionally shaved margins of the “residual lumpectomy cavity" as malignant breast tissues with intervening normal areas, was investigated in both groups. The study was conducted through the period from November, 2017 to March, 2021. Results: Forty-two patients with median age of 43 years were studied. Group A included 32 patients (76.2%) compared with 10 (23.8%) in group B. Overall, OMFBC was confirmed in the additionally shaved margins in 6 (14.3%) patients. OMFBC rate was less in group A (4/32 patients, 12.5%) compared to B (2/10 patient, 20%), however the difference did not reach statistical significance. In group B, another 1 patient showed persistent positive margins without evidence of OMFBC. All 7 patients with positive CS margins (6 with OMFBC and 1 with persistent positive margin without evidence of OMFBC) had their treatment strategy switched to modified radical mastectomy. Local recurrence occurred in only one among the remaing 35 patients (2.9%) who were treated by BCS with CS. Conclusions: CS improves outcome of BCS by reducing the rate of positive margins, enabling diagnosis of occult multifocal breast cancer and reducing local recurrence.  

DOI

10.21608/ejhm.2021.204584

Keywords

breast cancer, Conservative surgery, Cavity shave margin

Authors

First Name

Mohamed Mahmoud

Last Name

Ali

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Email

drmohamedmahmoud1969@gmail.com

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Orcid

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First Name

Emad

Last Name

Gomaa

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Orcid

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First Name

Ashraf Mohammad

Last Name

El-Badry

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Volume

85

Article Issue

2

Related Issue

28296

Issue Date

2021-10-01

Receive Date

2021-11-13

Publish Date

2021-10-01

Page Start

3,831

Page End

3,837

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_204584.html

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https://ejhm.journals.ekb.eg/service?article_code=204584

Order

63

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Routine Margin Shaving Of Lumpectomy Cavity During Breast Conserving Surgery Detects Occult Multifocal Cancer, A Prospective Study

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Article

Created At

22 Jan 2023