Predictive factors of positive margins in the treatment of ductal carcinoma in situ

Abstract

The purpose of this study was to determinate, through a literature review, possible factors related to positive margins in patients treated with surgery for ductal carcinoma in situ (DCIS). The Medical Literature Analysis and Retrieval System Online (MEDLINE ® ) database were used to search the articles, with the expressions: “Ductal carcinoma in situ” “in situ breast cancer” and “DCIS”. Ad- ditional terms included were “surgery” and “margin”. The reference period of these studies was from February 2000 to February 2015. A total of 438 articles were found, and six of them were included in this review, with a total of 1,222 patients. The rate of positive margins studies varied from 29 to 72%. The main variables related to positive margins were the histological grade and the final size of the lesion in paraffin (three studies), multifocality (one study) and volume of the resected specimen (one study). Surgical margins represent, undoubtedly, one of the most important factors of local recurrence in the treatment of DCIS. Larger studies are needed, with adequate methodology, to safely stratify the risk factors associated with surgical margins involvement.