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Lumpectomy and Surgical Margins

BIDMC Pathologist Stuart Schnitt, MD, addresses a controversial issue

Over the past 20 years, rigorous clinical trials have demonstrated that lumpectomy followed by radiation therapy is as effective as mastectomy for the treatment of breast cancer, providing female patients with a breast-conserving treatment option. During lumpectomy, surgeons remove both the primary tumor and a rim of normal tissue surrounding the tumor, which is referred to as the "surgical margin."

"This institution was among the first in the U.S. to promote the combination of breast-conserving surgery and radiation therapy as an alternative to mastectomy for the treatment of patients with early stage breast cancer," says BIDMC's Stuart Schnitt, MD, Director of Anatomic Pathology. "Our extensive clinical experience  led to numerous clinical and clinco-pathologic studies that helped identify those patients at greater risk for tumor recurrence in the treated breast, and the results of these studies allowed us to refine patient selection criteria and the details of surgery and radiation therapy for patients undergoing the breast-conserving approach."

 Schnitt is the co-author of a "Sounding Board" commentary that appeared in July 2012 in  The New England Journal of Medicine (NEJM), in which he discussed the debate surrounding the size of surgical margins and its impact to patients. Here, he discusses this debate.

To read the New England Journal of Medicne "Sounding Board" article, Surgical Margin in Lumpectomy for Breast Cancer - Bigger is Not Better, click here.