Singletary S Eva
Department of Surgical Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Box 444, Houston TX 77030-4095, USA.
Am J Surg. 2002 Nov;184(5):383-93. doi: 10.1016/s0002-9610(02)01012-7.
Patients receiving breast conservation therapy have a lifelong risk of local recurrence. To minimize this risk, surgeons have explored various approaches to examining the surgical margins of the resection specimen. If tumor cells are found at the margin, there is a high probability that residual tumor remains in the surgical cavity. This review examines published reports about standard and innovative approaches to assessing surgical margins, the clinical significance of margin size, and risk factors for positive margins.
Published literature abstracted in Medline was reviewed using the Gateway site from the National Library of Medicine.
It is still not clear whether obtaining a radical margin will decrease the rate of local recurrence after breast conserving surgery. What is clear is that it is absolutely unacceptable to have tumor cells directly at the cut edge of the excised specimen, regardless of the type of post-surgical adjuvant therapy.
接受保乳治疗的患者有终生局部复发风险。为将此风险降至最低，外科医生探索了多种检查切除标本手术切缘的方法。如果在切缘发现肿瘤细胞，则手术腔内很可能残留有肿瘤。本综述考察了已发表的关于评估手术切缘的标准方法和创新方法、切缘大小的临床意义以及切缘阳性的危险因素的报告。
使用美国国立医学图书馆的网关网站检索了Medline中收录的已发表文献摘要。
目前仍不清楚获得根治性切缘是否会降低保乳手术后的局部复发率。明确的是，无论术后辅助治疗的类型如何，切除标本的切缘直接存在肿瘤细胞是绝对不可接受的。
