Achieving Tumor Free Margins: Intraoperative Pathology Consultation to Lower Re-Excision Rates at a Community Hospital - Gynecology & Womens Health

Breast conserving therapy (BCT) is the surgical excision of a tumor followed by whole-breast  radiation for breast pathology  including  DCIS and stage I and II invasive  breast  cancer. The goal  of  BCT  is  to  achieve  adequate  margins  at  the  index  surgery.  Historically, breast tumor margins were ill-defined and with the lack of consensus on adequate margins in DCIS, the Society of Surgical Oncology (SSO), American Society for Radiation Oncology (ASTRO), and  the  American  Society  of  Clinical  Oncology  (ASCO)  published  guideline  recommendations  in  2014  and  2016.  For  stages  I  and  II invasive ductal carcinoma, no ink on tumor is consistent with negative margins and for DCIS, margins free of tumor for least 2mm is adequate. Since this consensus, there was significant decrease seen with ipsilateral tumor recurrence [1].

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