Low recurrence breast cancer rates with negative margins

cp418

http://www.oncologynurseadvisor.com/low-recurrence-breast-cancer-rates-with-negative-margins/article/334131/

Low recurrence breast cancer rates with negative margins

 

wallycat

Can someone smarter than me provide more detail...

so are they saying that the 1mm or 2mm clear-margin that is supposed to be standard is no longer an issue as long

as there is no "ink?" and is this "ink" a new method or is this what they currently did in surgery to attain good margins?

Jelson

I think inking is the current method used. I had surgery in 2009 and this is how my bs explained it to me: the tumor is rolled in ink so that the outside of the tissue removed is marked. Then the pathologist slices it up. There should be no cancer cells colored by ink. The outside of the tissue which is identified by the ink should be cancer-free (negative margins).  I think what this study is saying is that 1 cell width of cancer free cells at the margin (inked)  is as good as 1mm or 2mm. No need to go back and get wider margins.  I am wondering how this impacts the choice of additional therapies ie radiation/hormonal. Many women with DCIS choose to forgo radiation if they have wide margins. I don't think this study supports that - but I am not sure.  - I was trying to get the original journal article but it looks like you have to subscribe/pay for it. 

where are you, smart people????

farmerlucy

Jelson - Do you know how they roll the tumor in ink? I guess they can see it with the naked eye? Is it still attached at the inking point? I know, I know - weird questions, huh. If you can enlighten me I would really appreciate it!!

TB90

There are six sides to all pathology samples.  Each side is marked with a different color.  Basically, the surgeon marks the tissue removed (or an associate). That way, the pathologist knows where the margins were in relation to your body.  If a margin is positive, they know where that was.  Anterior (skin) is one color, posterior (deep or chest wall) another color, superior (top) and so on.  This study is suggesting that as long as there are no cancer cells on the ink, then the margin is considered negative.  It is allowing very close margins.

TB90

This study looks a little iffy to me and some of the researchers have disclosed financial interests. 

wyo

I believe this link does a much better job of describing the consensus opinion who/why it was derived etc.  The financial interests disclosed are Genomic Health home of the Oncotype Dx.   

http://www.medpagetoday.com/HematologyOncology/Bre...

http://www.breastcancer.org/symptoms/diagnosis/margins

farmerlucy

TB90 - Thanks for the informative tutorial! One learns something new everyday!

farmerlucy

wyo - In the picture on the medpage link - what is the surgeon doing and what is he holding with each hand? Thanks so much! You are an incredible resource for all of us!