On this page you will find information about and links to relevant margins publications



This systematic review aimed to determine if pathological margin proximity is associated with local or distant recurrence for patients with early invasive breast cancer or ductal carcinoma in situ who were treated with mastectomy (including skin sparing mastectomy). 34 studies (n=34,833 patients) were included for analysis. Positive margins were associated with increased risk of local and distant recurrence. Patients with a positive or close margin are at two to threefold increased risk of local recurrence.

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Annals of Surgical Oncology (2019) 26: 4246-4253

Women with dense breasts may have less accurate pre-operative imaging estimation of tumour size. This may in turn affect the margin re-excision rates in women receiving breast conserving surgery (BCS). This study examined the association between breast density (using the BIRADS classification) and re-excision rates in 701 patients with invasive breast cancer. 15.1% of women had at least one re-excision. Younger age was associated with increased breast density (p<0.001). Median tumour size was 1.2cm (range 0.1-4.5cm) with multifocal disease present in 19.8%. MRI was performed in 14.7% of patients, and more frequently utilised in women with denser breasts (27.6% vs. 9%; p<0.001). Extensive Intraductal Component (EIC) was seen in 7.4%.

On multivariate analysis, breast density was significantly associated with increased odds of re-excision (OR 1.37; p=0.049), as did multifocality (p<0.001) and the presence of EIC. The study findings support the need for developing techniques that can reduce re-excision rates for women with dense breasts who undergo BCS.

Shave margins reduce positive margin rates

Journal: Annals of Surgery

Shave margins reducer re-excision rate by 50% but increase volume of excised tissue

Journal: NEJM