Surgery · Breast (Benign, Carcinoma Breast, Staging, Treatment)

A 45-year-old woman undergoes wide local excision for a 1.5 cm invasive ductal carcinoma. The closest surgical margin is 1 mm. According to current guidelines, what is the recommended management?

  • A Re-excision to achieve a wider margin
  • B Mastectomy
  • C No further surgery needed, proceed to radiotherapy
  • D Adjuvant chemotherapy alone
Correct answer: C. No further surgery needed, proceed to radiotherapy

Explanation

For invasive breast cancer treated with breast-conserving surgery, a negative margin is defined as no tumor on ink. A 1 mm margin is considered adequate, and re-excision is not required. Re-excision is indicated only when tumor cells are present at the inked margin. This no tumor on ink standard is supported by consensus guidelines.

Reference: Sabiston Textbook of Surgery, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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