Hz. Malik et al., Margin assessment by cavity shaving after breast-conserving surgery: analysis and follow-up of 543 patients, EUR J SUR O, 25(5), 1999, pp. 464-469
Aims: To analyse cavity shaving as a method of assessing completeness of su
rgical excision after breast-conserving surgery.
Methods: Shavings were taken from the wall of the cavity remaining in the b
reast after breast-conserving surgery in 543 women. Each shaving was extens
ively sectioned and the presence and type of microscopic disease recorded.
Disease in cavity shavings (tumour bed positivity) was correlated with clin
icopathological factors as well as overall survival.
Results: Tumour bed positivity (TBP) was found in 37% of patients (16% with
invasive disease). Patients were selected for further surgery according to
the extent of positivity, which varied widely. A total of 15% of patients
underwent re-excision or mastectomy. TBP was significantly associated with
high tumour grade, presence of an extensive intraduct component, young age
and large tumour diameter. It was also associated with a significantly shor
ter overall survival when compared to patients who were tumour bed negative
.
Conclusions: Cavity shaving is a practical and sensitive method of assessin
g completeness of excision after breast-conserving surgery. In addition it
may provide useful prognostic information.