J Breast Cancer.  2017 Dec;20(4):400-403. 10.4048/jbc.2017.20.4.400.

The Practice Patterns and Perceptions of Korean Surgeons Regarding Margin Status after Breast-Conserving Surgery

Affiliations
  • 1Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
  • 2Department of Surgery, Daerim St. Mary's Hospital, Seoul, Korea. brcakorea@gmail.com
  • 3Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
  • 4Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 5Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
  • 6Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
  • 7Department of Surgery, Korea University Guro Hospital, Seoul, Korea.
  • 8Department of Surgery, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea.
  • 9Department of Surgery, Chungbuk National University College of Medicine, Cheongju, Korea.
  • 10Department of Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea.
  • 11Department of Surgery, Dankook University College of Medicine, Cheonan, Korea.
  • 12Department of Surgery, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Korea.

Abstract

Two consecutive surveys for breast surgeons in Korea were conducted to comprehend the practice patterns and perceptions on margin status after breast-conserving surgery. The surveys were conducted online in 2014 (initial) and 2016 (follow-up). A total of 126 and 88 responses were obtained in the initial and follow-up survey, respectively. More than 80% of the respondents replied to routinely apply frozen section biopsy for intraoperative margin assessment in both surveys. Re-excision recommendations of the margin for invasive cancer significantly changed from a close margin to a positive margin over time (p=0.033). Most of the respondents (73.8%) defined a negative margin as "no ink on tumor" in invasive cancer, whereas more diverse responses were observed in ductal carcinoma in situ cases. The influence of guideline establishment for negative margins has been identified. A high uptake rate of intraoperative frozen section biopsy was noted and routine use needs reconsideration.

Keyword

Frozen sections; Margins of excision; Segmental mastectomy; Surveys and questionnaires

MeSH Terms

Biopsy
Breast
Carcinoma, Intraductal, Noninfiltrating
Follow-Up Studies
Frozen Sections
Ink
Korea
Mastectomy, Segmental*
Surgeons*
Surveys and Questionnaires

Figure

  • Figure 1 Percentages of intraoperative pathology assessment of resection margin.

  • Figure 2 Definition of negative margin in breast-conserving surgery (follow-up survey only). DCIS=ductal carcinoma in situ.


Reference

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