Annals of Surgical Oncology

, Volume 19, Issue 3, pp 886–891

Volume of Excision and Cosmesis with Routine Cavity Shave Margins Technique

Authors

  • Julie Mook
    • Division of Surgical Oncology, Department of SurgeryUniversity of Texas Southwestern Medical Center
  • Rebecca Klein
    • Division of Surgical Oncology, Department of SurgeryUniversity of Texas Southwestern Medical Center
  • Anne Kobbermann
    • Division of Surgical Oncology, Department of SurgeryUniversity of Texas Southwestern Medical Center
  • Alison Unzeitig
    • Division of Surgical Oncology, Department of SurgeryUniversity of Texas Southwestern Medical Center
  • David Euhus
    • Division of Surgical Oncology, Department of SurgeryUniversity of Texas Southwestern Medical Center
  • Yan Peng
    • Department of PathologyUniversity of Texas Southwestern Medical Center
  • Venetia Sarode
    • Department of PathologyUniversity of Texas Southwestern Medical Center
  • Amy Moldrem
    • Division of Surgical Oncology, Department of SurgeryUniversity of Texas Southwestern Medical Center
  • A. Marilyn Leitch
    • Division of Surgical Oncology, Department of SurgeryUniversity of Texas Southwestern Medical Center
  • Valerie Andrews
    • Division of Surgical Oncology, Department of SurgeryUniversity of Texas Southwestern Medical Center
  • Sumeet Teotia
    • Department of Plastic SurgeryUniversity of Texas Southwestern Medical Center
    • Division of Surgical Oncology, Department of SurgeryUniversity of Texas Southwestern Medical Center
Breast Oncology

DOI: 10.1245/s10434-011-1982-y

Cite this article as:
Mook, J., Klein, R., Kobbermann, A. et al. Ann Surg Oncol (2012) 19: 886. doi:10.1245/s10434-011-1982-y

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.

Copyright information

© Society of Surgical Oncology 2011