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ASTRO and SSO issue consensus guideline on margins for breast-conserving surgery with WBI
Date:2/10/2014

ior to approval by the SSO Executive Council and ASTRO's Board of Directors in October 2013. In addition, the American Society of Breast Surgeons and the American Society of Clinical Oncology (ASCO) have both endorsed the guideline. It is available open access online as a PDF document at http://www.redjournal.org, http://www.annsugoncol.org and http://jco.ascopubs.org/, and will be published in the March 1, 2014 print issue of the International Journal of Radiation Oncology Biology Physics (Red Journal), the official scientific journal of ASTRO; the March 2014 print issue of Annals of Surgical Oncology, the official journal of SSO; and the March 10, 2014 issue of the Journal of Clinical Oncology, the official journal of ASCO.

The consensus guideline includes eight clinical practice recommendations: 1) positive margins, defined as ink on invasive cancer or DCIS, are associated with at least a two-fold increase in IBTR. This increased risk is not nullified by delivery of a boost, delivery of systemic therapy or favorable biology; 2) negative margins (no ink on tumor) optimize IBTR. Wider margin widths do not significantly lower this risk; 3) the rates of IBTR are reduced with the use of systemic therapy. In the event that a patient does not receive adjuvant systemic therapy, there is no evidence suggesting that margins wider than no ink on tumor are needed; 4) margins wider than no ink on tumor are not indicated based on biologic subtype; 5) the choice of whole-breast irradiation delivery technique, fractionation and boost dose should not be dependent on margin width; 6) wider negative margins than no ink on tumor are not indicated for invasive lobular cancer. Classic lobular carcinoma in situ (LCIS) at the margin is not an indication for re-excision. The signific
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Contact: Michelle Kirkwood
press@astro.org
703-286-1600
American Society for Radiation Oncology
Source:Eurekalert

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