Re-excision for close margins?
Meet the Experts
Beth Baughman DuPree, M.D., F.A.C.S. is a general surgeon with a focus in breast cancer care and the CEO and medical director of the Comprehensive Breast Care Institute at DSI of Bucks County, PA.
Ann Ainsworth, M.D. is a surgical pathologist at Paoli, Bryn Mawr, and Lankenau Hospitals in Pennsylvania.
Marisa Weiss, M.D., a Philadelphia oncologist, is the founder and president of Breastcancer.org.
Question from Chrissy: My pathology report says that the margins were close. They are recommending doing a re-excision. Is this my best option?
- Answers —Ann Ainsworth, M.D.: The surgical margins are examined by the pathologist. We ink the surgical surface so we can see the relationship between the tumor and the cut surface or surgical margin of the excision. The ink shows up on the slides we examine. Tumor cells can be at the surgical margins, close to the surgical margins, or the surgical margins can be negative (free of cancer). A close surgical margin means the tumor is 1-2 mm from the inked surface of the surgical excision.
- Marisa Weiss, M.D., president and founder: The definition of a negative margin can vary from one hospital to another. At some institutions, if there is one normal cell between the cancer and the edge of the breast specimen (the margin), then the margin is called "negative."
- Beth DuPree, M.D., F.A.C.S.: Re-excision is acceptable as long as the cosmetic results from the re-excision and subsequent radiation therapy are acceptable to the patient as an alternative to mastectomy.
On Wednesday, November 17, 2004, our Ask-the-Expert Online Conference was called Your Operative and Pathology Reports. Beth Baughman Dupree, M.D., F.A.C.S. and Ann Ainsworth, M.D. answered your questions about details of pathology and operative reports and the importance of discussing them with your doctors.
The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.
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