%0 Journal Article
%T Preoperative Localization and Surgical Margins in Conservative Breast Surgery
%A F. Corsi
%A L. Sorrentino
%A D. Bossi
%A A. Sartani
%A D. Foschi
%J International Journal of Surgical Oncology
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/793819
%X Breast-conserving surgery (BCS) is the treatment of choice for early breast cancer. The adequacy of surgical margins (SM) is a crucial issue for adjusting the volume of excision and for avoiding local recurrences, although the precise definition of an adequate margins width remains controversial. Moreover, other factors such as the biological behaviour of the tumor and subsequent proper systemic therapies may influence the local recurrence rate (LRR). However, a successful BCS requires preoperative localization techniques or margin assessment techniques. Carbon marking, wire-guided, biopsy clips, radio-guided, ultrasound-guided, frozen section analysis, imprint cytology, and cavity shave margins are commonly used, but from the literature review, no single technique proved to be better among the various ones. Thus, an association of two or more methods could result in a decrease in rates of involved margins. Each institute should adopt its most congenial techniques, based on the senologic equipe experience, skills, and technologies. 1. Introduction Breast-conserving surgery (BCS) is the treatment of choice for early breast cancer [1, 2]. Various randomized trials have reported this approach to be safe and effective, thus determining a decrease in the adoption of mastectomy as the treatment of choice for early invasive breast cancer [3, 4]. BCS can almost be considered the gold standard of early stage invasive breast cancer treatment, allowing to achieve adequate surgical margins (SM) with an acceptable cosmetic outcome. Some studies have defined the adequacy of SM by its correlation with the locoregional recurrence rate (LRR) [5¨C14], but the precise definition of an adequate margins width remains controversial [15¨C17]. However, there is no doubt that obtaining negative margins decreases the risk of local recurrence [1]. Some clinical trials have demonstrated that systemic therapies may also improve the local control in breast cancer [18, 19]. Thus, there seems to be noted a recent trend of reconsideration of the importance of margin width on the incidence of local recurrences, in favour of other prognostic factors such as the biological behaviour of the tumor [15¨C19]. A requirement for successful BCS is a careful preoperative planning with proper localization of the lesion, especially in nonpalpable breast lesions [1]. In order to obtain adequate excisions, margins assessment techniques are also available. Wire-guided localization, radio-guided occult lesion localization (ROLL), carbon marking, intraoperative ultrasound-guided localization, cavity shave
%U http://www.hindawi.com/journals/ijso/2013/793819/