A 45-year-old woman with a 2.5 cm invasive ductal carcinoma undergoes breast conservation surgery. The final pathology shows a close margin (<1 mm) anteriorly. What is the most appropriate next step?
- A Re-excision to achieve clear margins ✓
- B Mastectomy
- C Boost radiotherapy to the tumor bed
- D Adjuvant chemotherapy
Correct answer: A. Re-excision to achieve clear margins
Explanation
A positive or close margin after breast conservation surgery is an indication for re-excision to achieve clear margins, which reduces the risk of local recurrence. Mastectomy is an option if clear margins cannot be achieved or if there is extensive disease. Boost radiotherapy does not substitute for clear margins.
Reference: Sabiston Textbook of Surgery, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.