The surgical margin was involved with epithelial dysplasia but free of OIN/CIS.
The first patient had a positive bone margin while in the second the buccal margin was involved.
This may suggest that tumor cells were shed during surgical manipulation of the tumour, however the surgical margin was involved with tumour in both cases and there was evidence of extracapsular spread in Patient 10.
Radiotherapy is given post-operatively if surgical margins are involved and a further resection is not possible [ 4- 6].
In patients with positive margins on initial lumpectomy specimens, an average of two margins was involved, with no difference between the two arms.
For two of these patients (Patients 2 and 5) the margins were involved after surgery and there was evidence of either lymphovascular (Patient 2) or extracapsular spread (Patient 5) on pathological examination.
At Dartmouth, the breast-resection specimens are inked with six pre-assigned colors to preserve orientation within the breast, so that, if it is found by pathologic evaluation that the margins are involved by tumor, the patient is called back to undergo a second resection of those specific margins rather than the entire surgical cavity.
Evidence for this comes from large studies of breast-conserving therapy where more than 90% of early breast recurrences were found to occur at the site of the original primary tumour site, whether or not radiotherapy was given and/or the margins were involved [ 2, 3].
Transfusion rates per se, and rates for transfusions with 3 or more units, were highest for free-flap surgery patients with more advanced stages of disease, when soft-tissue margins were involved, with perineural invasion, for segmental resection and for composite-flap surgery (Table 2).
When the tumour invades the MRF or extends within a margin of <1 mm, the MRF <span class="lh">is involved.
