Patients with triple-negative breast cancer face an increased risk of residual cancer after a lumpectomy, making the need for generous margins especially important, according to research published in the Journal of the Academy of Physician Assistants.  Some details:
• Surgical specimens from 369 women with invasive breast cancer were examined.
• 51 percent of those with TNBC had invasive cancer in their surgical specimens.
• 30 percent of those with non-TNBC had invasive cancer in their surgical specimens,
• This means that clear margins are especially essential for those with TNBC.   Patients without clear margins might need re-excisions.

Remember: This is one study, of only 369 women.  In it, the odds of residual disease are high for all those studied—those with TNBC and those with non-TNBC.  Yet most women typically survive at far higher odds than in this study.  One reason for this may be that these specimens were taken before chemotherapy and radiation, which kill residual disease.

The bottom line: Clear margins are essential.

Additional Note:  A new device might help determine the existence of cancer on surgical margins.  In a paper  presented at the  2012  American Society of Clinical Oncology Breast Cancer Symposium in San Francisco, researchers demonstrated that the MarginProbe device found positive margins and reduced the need to re-exisions in a large, prospective trial.  Check out the article on Cancer Network.

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