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01-03-2012 | Breast Oncology

Volume of Excision and Cosmesis with Routine Cavity Shave Margins Technique

Authors: Julie Mook, MD, Rebecca Klein, MD, Anne Kobbermann, MD, Alison Unzeitig, BS, David Euhus, MD, Yan Peng, MD, PhD, Venetia Sarode, MD, Amy Moldrem, MD, A. Marilyn Leitch, MD, Valerie Andrews, MD, Sumeet Teotia, MD, Roshni Rao, MD

Published in: Annals of Surgical Oncology | Issue 3/2012

Abstract

Background

Cavity shave margin (CSM) removal is a surgical technique that reduces re-excision rates. One criticism of this technique has been that negative margins are obtained primarily as a result of higher volumes of tissue removed. This study evaluates the volume of tissue removed in a group that underwent CSM versus one that underwent standard partial mastectomy (SPM) and explores cosmetic outcomes.

Methods

Single-institution retrospective review identified 533 patients with a diagnosis of breast cancer who underwent PM. Matched pair analysis of 72 patients who had undergone PM with CSM versus 72 who had undergone SPM was performed. Volumes were calculated from dimensions in the pathology report. A subgroup was analyzed by a multidisciplinary panel for cosmetic outcome using the Harvard Breast Cosmesis Grading Scale.

Results

Mean tumor size in the CSM group was 1.52 versus 1.51 cm³ in the SPM (P = 0.8073). Mean total volume of tissue excised with CSM was lower than that in the SPM group. Mean volume of excision with CSM was 80.66 and 165.1 cm³ in the SPM group (P = 0.0005). Patients undergoing CSM required fewer re-excisions than the SPM group: 13 (18.1%) versus 25 (34.6%) (P = 0.03). Mean score for cosmesis was 2.3 in the CSM group and 3.0 for SPM (P = 0.0004).

Conclusions

CSM decreases the need for re-excision. Total tissue volume excised is lower in patients who undergo CSM, and cosmetic results appear to be improved. This approach should be considered for all patients undergoing PM.

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Title: Volume of Excision and Cosmesis with Routine Cavity Shave Margins Technique
Authors: Julie Mook, MD
Rebecca Klein, MD
Anne Kobbermann, MD
Alison Unzeitig, BS
David Euhus, MD
Yan Peng, MD, PhD
Venetia Sarode, MD
Amy Moldrem, MD
A. Marilyn Leitch, MD
Valerie Andrews, MD
Sumeet Teotia, MD
Roshni Rao, MD
Publication date: 01-03-2012
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 3/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-011-1982-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Volume of Excision and Cosmesis with Routine Cavity Shave Margins Technique

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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