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Difference between revisions of "Surgical margins"
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→Positive margin definition
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Unfortunately, there is no universal definition for ''positive margin''. | Unfortunately, there is no universal definition for ''positive margin''. | ||
Definitionally, there is agreement that "tumour touching the edge of the specimen" is a ''positive margin''.<ref>{{cite journal |authors=Chagpar AB, Killelea BK, Tsangaris TN, Butler M, Stavris K, Li F, Yao X, Bossuyt V, Harigopal M, Lannin DR, Pusztai L, Horowitz NR |title=A Randomized, Controlled Trial of Cavity Shave Margins in Breast Cancer |journal=N Engl J Med |volume=373 |issue=6 |pages=503–10 |date=August 2015 |pmid=26028131 |pmc=5584380 |doi=10.1056/NEJMoa1504473 |url=}}</ref> | Definitionally, there is agreement that "tumour touching the edge of the specimen" is a ''positive margin''.<ref name=pmid26028131>{{cite journal |authors=Chagpar AB, Killelea BK, Tsangaris TN, Butler M, Stavris K, Li F, Yao X, Bossuyt V, Harigopal M, Lannin DR, Pusztai L, Horowitz NR |title=A Randomized, Controlled Trial of Cavity Shave Margins in Breast Cancer |journal=N Engl J Med |volume=373 |issue=6 |pages=503–10 |date=August 2015 |pmid=26028131 |pmc=5584380 |doi=10.1056/NEJMoa1504473 |url=}}</ref> | ||
It may be useful to differentiate ''pathologic margin'' (tumour touching ink) and ''oncologic margin'' (tumour sufficiently clear of margin to not affect the prognosis). Oncologists, surgeons and patients really only care about ''oncologic margin'' for relatively obvious reasons. | It may be useful to differentiate ''pathologic margin'' (tumour touching ink) and ''oncologic margin'' (tumour sufficiently clear of margin to not affect the prognosis). Oncologists, surgeons and patients really only care about ''oncologic margin'' for relatively obvious reasons. | ||
Perhaps confusing is that: ''[pathologically] clear margins'' are defined to be ''positive margin''.<ref>{{cite journal |authors=Scopa CD, Aroukatos P, Tsamandas AC, Aletra C |title=Evaluation of margin status in lumpectomy specimens and residual breast carcinoma |journal=Breast J |volume=12 |issue=2 |pages=150–3 |date=2006 |pmid=16509840 |doi=10.1111/j.1075-122X.2006.00223.x |url=}}</ref> | Perhaps confusing is that: ''[pathologically] clear margins'' are defined to be ''positive margin'', the tumour is less than 1 mm is a "positive margin".<ref name=pmid16509840>{{cite journal |authors=Scopa CD, Aroukatos P, Tsamandas AC, Aletra C |title=Evaluation of margin status in lumpectomy specimens and residual breast carcinoma |journal=Breast J |volume=12 |issue=2 |pages=150–3 |date=2006 |pmid=16509840 |doi=10.1111/j.1075-122X.2006.00223.x |url=}}</ref> | ||
==Adequate margin== | ==Adequate margin== | ||