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Ds2-21 shows a clear excision band in the F1, whereas Ds2-31 does not, indicating that the former can transpose in response to Ac, but the latter cannot.
In accordance with this trial, a retrospective study 81 and an exploratory subgroup analysis of a randomized trial 82 identified a subgroup of patients with a low risk of local recurrence (T1 T2, node-negative, grade 1 tumors ≤1 cm, HR-positive) after BCS with a clear excision margin in whom postoperative radiotherapy could be omitted.
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100, 101 This is an option for low-risk patients (ER-positive, no nodal involvement, no lymphovascular invasion, grade 1 2, clear excision margins).
○ Clear excision margins: Whole breast radiotherapy should be performed (standard) with an additional dose to the tumour bed (boost) if the patient is under 50 years old (standard).
Of the 46 cases of HG-SIL in our study with histologically clear excision margins and adequate follow-up data, six (13%) recurred.
There was little further change in tumour size and, 126 days after starting chemotherapy, the tumour was surgically removed with clear excision margins and eculizumab was discontinued.
In our setting, it appears reasonable for HIV negative women who have clear excision margins to have less intensive follow up, at the level of a community health centre.
Immediate breast reconstruction can be considered if there are no other risk factors for locoregional recurrence and/or this does not prejudice the administration of additional treatment (option).. ○ Clear excision margins: Whole breast radiotherapy should be performed (standard) with an additional dose to the tumour bed (boost) if the patient is under 50 years old (standard).
Tumor shrinkage has a clear benefit for local excision in terms of feasibility and function preservation.
For resectable local/in-transit recurrences, excision with a clear margin is recommended.
The standard treatment is surgical excision, with a clear resection margin of more than 1 cm to minimize the risk of recurrence.
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