Corsi F, Sorrentino L, Bossi D, Sartani A, Foschi D
Surgery Division, Department of Clinical Sciences, L. Sacco Hospital, University of Milan, Via G.B. Grassi 74, 20157 Milan, Italy.
Int J Surg Oncol. 2013;2013:793819. doi: 10.1155/2013/793819. Epub 2013 Aug 5.
Breast-conserving surgery (BCS) is the treatment of choice for early breast cancer. The adequacy of surgical margins (SM) is a crucial issue for adjusting the volume of excision and for avoiding local recurrences, although the precise definition of an adequate margins width remains controversial. Moreover, other factors such as the biological behaviour of the tumor and subsequent proper systemic therapies may influence the local recurrence rate (LRR). However, a successful BCS requires preoperative localization techniques or margin assessment techniques. Carbon marking, wire-guided, biopsy clips, radio-guided, ultrasound-guided, frozen section analysis, imprint cytology, and cavity shave margins are commonly used, but from the literature review, no single technique proved to be better among the various ones. Thus, an association of two or more methods could result in a decrease in rates of involved margins. Each institute should adopt its most congenial techniques, based on the senologic equipe experience, skills, and technologies.
保乳手术(BCS)是早期乳腺癌的首选治疗方法。手术切缘(SM)的充分性是调整切除范围和避免局部复发的关键问题,尽管切缘宽度足够的精确定义仍存在争议。此外,其他因素,如肿瘤的生物学行为和后续适当的全身治疗,可能会影响局部复发率(LRR)。然而,成功的保乳手术需要术前定位技术或切缘评估技术。常用的方法有碳标记、钢丝引导、活检夹、放射性引导、超声引导、冰冻切片分析、印片细胞学检查和腔面剃须切缘,但从文献综述来看,在各种方法中没有一种方法被证明更好。因此,两种或更多方法的联合应用可能会降低切缘受累率。每个机构应根据乳腺科团队的经验、技能和技术,采用最适合自己的技术。