Breast Oncology

Annals of Surgical Oncology

, Volume 19, Issue 3, pp 886-891

First online:

Volume of Excision and Cosmesis with Routine Cavity Shave Margins Technique

  • Julie MookAffiliated withDivision of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center
  • , Rebecca KleinAffiliated withDivision of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center
  • , Anne KobbermannAffiliated withDivision of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center
  • , Alison UnzeitigAffiliated withDivision of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center
  • , David EuhusAffiliated withDivision of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center
  • , Yan PengAffiliated withDepartment of Pathology, University of Texas Southwestern Medical Center
  • , Venetia SarodeAffiliated withDepartment of Pathology, University of Texas Southwestern Medical Center
  • , Amy MoldremAffiliated withDivision of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center
  • , A. Marilyn LeitchAffiliated withDivision of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center
    • , Valerie AndrewsAffiliated withDivision of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center
    • , Sumeet TeotiaAffiliated withDepartment of Plastic Surgery, University of Texas Southwestern Medical Center
    • , Roshni RaoAffiliated withDivision of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center Email author 

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Abstract

Background

Cavity shave margin (CSM) removal is a surgical technique that reduces re-excision rates. One criticism of this technique has been that negative margins are obtained primarily as a result of higher volumes of tissue removed. This study evaluates the volume of tissue removed in a group that underwent CSM versus one that underwent standard partial mastectomy (SPM) and explores cosmetic outcomes.

Methods

Single-institution retrospective review identified 533 patients with a diagnosis of breast cancer who underwent PM. Matched pair analysis of 72 patients who had undergone PM with CSM versus 72 who had undergone SPM was performed. Volumes were calculated from dimensions in the pathology report. A subgroup was analyzed by a multidisciplinary panel for cosmetic outcome using the Harvard Breast Cosmesis Grading Scale.

Results

Mean tumor size in the CSM group was 1.52 versus 1.51 cm3 in the SPM (P = 0.8073). Mean total volume of tissue excised with CSM was lower than that in the SPM group. Mean volume of excision with CSM was 80.66 and 165.1 cm3 in the SPM group (P = 0.0005). Patients undergoing CSM required fewer re-excisions than the SPM group: 13 (18.1%) versus 25 (34.6%) (P = 0.03). Mean score for cosmesis was 2.3 in the CSM group and 3.0 for SPM (P = 0.0004).

Conclusions

CSM decreases the need for re-excision. Total tissue volume excised is lower in patients who undergo CSM, and cosmetic results appear to be improved. This approach should be considered for all patients undergoing PM.