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Difference between revisions of "Surgical margins"
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→Positive margin definition
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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><ref name=pmid16509840/> | 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><ref name=pmid16509840/> | ||
It may be useful to differentiate ''pathologic margin [status]'' (tumour touching inked margin) and ''oncologic margin [status]'' (tumour sufficiently clear of margin to not affect the prognosis). Oncologists, surgeons and patients really only care about ''oncologic margin [status]'' for relatively obvious reasons. | It may be useful to differentiate ''pathologic margin [status]'' (tumour touching inked margin) and ''oncologic margin [status]'' (tumour sufficiently clear of margin to not significantly affect the prognosis). Oncologists, surgeons and patients really only care about ''oncologic margin [status]'' for relatively obvious reasons. | ||
Perhaps confusing is that: ''a [pathologically] clear margin'' may be defined as being ''[oncologically] a positive margin'', e.g. tumour ''not'' touching the ink of an inked margin - but less than 1 mm from the ink - may be 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> | Perhaps confusing is that: ''a [pathologically] clear margin'' may be defined as being ''[oncologically] a positive margin'', e.g. tumour ''not'' touching the ink of an inked margin - but less than 1 mm from the ink - may be 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> | ||