Consensus guideline on margins for breast-conserving surgery with whole-breast irradiation in ductal carcinoma in situ

  • Publication
    Online – June 2016
    Print – September 2016

    This collaborative guideline focuses on several elements of optimal margin negative margin width for ductal carcinoma in situ treated with breast-conserving surgery and whole breast irradiation. It defines positive margins and provides recommendations on negative margin width. The guideline then discusses the impact on negative margin width of treatment with excision alone or with endocrine therapy; patient and tumor features; and DCIS in presence of invasive breast cancer. The document also looks at the role of margin width in choice of technique, fractionation and boost dose for whole breast irradiation. 

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    Quick Reference

    • Determination of optimal margin width to minimize risk of ipsilateral breast tumor recurrence
    • Whole-breast radiation therapy (WBRT) in combination with excision
    • Excision alone
    • Endocrine therapy
    • Consideration of unfavorable risk factors in determining margin width
    • Choice of WBFT delivery technique, fractionation and boost dose
    • Considerations for DCIS with microinvasion when determining optimal margin width

    Resources
    Radiation Therapy for Breast Cancer
    Summary Recommendation Table
    Summary Presentation

    Author Society
    American Society for Radiation Oncology
    American Society of Clinical Oncology
    Society of Surgical Oncology

    Previous version
    None

    Endorsements
    American Society of Breast Surgeons

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    ASTRO guidelines present scientific, health, and safety information and may reflect scientific or medical opinion. They are available to ASTRO members and the public for educational and informational purposes only. Commercial use of any content in this guideline without the prior written consent of ASTRO is strictly prohibited.