Published in:
01-12-2020 | Mastectomy | ASO Author Reflections
ASO Author Reflections: Evolving Paradigms in the Treatment of DCIS: Impact of the SSO-ASTRO Margin Guidelines
Authors:
Anita Mamtani, MD, Mary L. Gemignani, MD, MPH
Published in:
Annals of Surgical Oncology
|
Special Issue 3/2020
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Excerpt
Breast cancer treatment has evolved significantly in the modern era, with increasing use of tailored strategies aimed at optimizing oncologic outcomes and minimizing morbidity. While breast-conserving surgery (BCS) has been utilized for many years for the surgical treatment of ductal carcinoma in situ (DCIS), there has been a historical lack of consensus regarding ideal margin width required to decrease risk of local recurrence.
1 In 2016, evidence-based consensus guidelines were put forth by the Society of Surgical Oncology (SSO), the American Society for Radiation Oncology (ASTRO), and the American Society of Clinical Oncology (ASCO), advising 2 mm margins for patients with DCIS undergoing BCS and subsequent whole-breast radiotherapy.
2,3 While past dissemination of margin guidelines for invasive cancer led to a notable decrease in re-excisions for invasive disease, the impact of the guidelines on DCIS remains unclear. In the current study,
4 we sought to examine the effect of these guidelines on rates of additional surgery and identify factors predictive of re-excision. …
