What is the threshold for negative surgical margins in multifocal microinvasive carcinoma of the breast?
Do you follow invasive or DCIS guidelines? Would you consider re-excision in a patient with multifocal microinvasive carcinoma of the breast arising in grade 3 DCIS. DCIS 3.8cm, closest margin to DCIS < 0.1mm, closest margin to invasive disease 5mm.
Answer from: at Academic Institution
I think it is reasonable to forego re-excision in this case if the margin is focally (i.e. < 4 mm) less than 0.1 mm, and the patient proceeds with appropriate adjuvant therapies. Re-excision could be considered if the span of DCIS close to the margin is extensive. The panel who delivered the DCIS...
Answer from: Radiation Oncologist at Community Practice
By guidelines the surgical margins need to be 2 mm or more. However, in practice one should look at the extent of margin involvement (focal or diffuse), single or multiple, if the patient would receive anti estrogen therapy (as would help reduce odds), prior to RT the affect that additiona...
Comments
Radiation Oncologist at Weill Cornell Medical College agree.
This is how I practice in the clinic. Mam...