New Guidelines on the Adequacy of Lumpectomy Margin Width in Patients with Ductal Carcinoma In Situ

Purpose of Review Ductal carcinoma in situ (DCIS) can be successfully treated with breast-conserving surgery (BCS); however, there is little consensus regarding what negative margin width minimizes the risk of local recurrence, and as many as one third of patients undergo additional surgery after initial lumpectomy. Recent Findings An evidence-based SSO-ASTRO-ASCO consensus guideline on margin width for patients treated with BCS and whole breast irradiation found a margin width of 2 mm to be optimal, and that margins greater than 2 mm did not further reduce local recurrence rates. Multiple factors determine the need for re-excision in patients with negative margins less than 2 mm. Summary There has been much debate regarding the appropriate negative margin width after BCS for DCIS. The new consensus guideline has provided a standard negative margin definition which may reduce rates of re-excision.