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Surgical Technique May Cut Positive Margin Rates in DCIS

Cavity shave margin resections for pure ductal carcinoma in situ may lower risk for positive margins

WEDNESDAY, April 21, 2021 (HealthDay News) — Cavity shave margin (CSM) resections may reduce positive margin rates in patients with pure ductal carcinoma in situ (DCIS), according to a study published in the April issue of the Journal of the American College of Surgeons.

Marissa Howard-McNatt, M.D., from Wake Forest University in Winston-Salem, North Carolina, and colleagues examined the impact of CSMs on margin status in patients with DCIS undergoing partial mastectomy. Following partial mastectomy performed per the surgeon’s discretion, 109 patients were randomly assigned to CSM resection (58) or not.

The researchers found that 56.9 percent of the patients in the shave group had a positive margin before randomization, but only 20.7 percent had a positive margin after randomization to CSM compared with 33.3 percent with a positive margin in the no-shave group. CSM was associated with a significant reduction in the positive margin rate (odds ratio, 0.366) when controlling for size and grade of DCIS. Size of DCIS persisted as an independent predictor of positive margins (odds ratio, 1.646).

“Our study shows a significant reduction in positive margins,” Howard-McNatt said in a statement. “This technique should be considered for DCIS patients.”

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