Ductal Carcinoma In Situ Close to the Inked Margin: A Case Presented in Multidisciplinary Session With Clinical Discussion and Decision Making

Background: For many years, the acceptable margins of the resections forductal carcinoma in situ (DCIS) has been ۲ mm, although, in some reports and therecent updates of some guidelines, the closer margins are also declared asacceptable in some circumstances. Despite these new recommendations, the safemargin in DCIS remains a matter of controversy in many institutional and nationalguidelines. Case Presentation: A woman with invasive breast cancer with associated DCISpresented to our clinic. She underwent breast-conserving surgery, and pathologyreport showed one focus of DCIS at a distance of < ۱ mm from inked margin. Thiscase was presented in the weekly breast multidisciplinary team session of theDepartment of Breast Surgery, Tehran University of Medical Sciences. Question: The question was whether the patient should be operated again toobtain more extensive margins for DCIS or the radiation therapy would be enoughas the next step in her treatment. Conclusion: According to the latest published guidelines, the members of paneldecided to accept the margin and informed the patient about the risk of recurrenceand the need for adjuvant radiotherapy and follow-up modalities.

Keywords:

Breast cancer , ductal carcinoma In situ (DCIS(و inked margin , multidisciplinary team decision