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

Ahmad Elahi (1), Gholamreza Toogeh (2), Habibollah Mahmoodzadeh (3), Behnaz Jahanbin (4), Farhad Shahi (5), Bita Kalaghchi (6), Nahid Sedighi (7)
(1) Division of Breast Surgical Oncology, Department of Surgery, Alborz University of Medical Sciences, Karaj, Iran, Iran, Islamic Republic of,
(2) Hematology and Medical Oncology Department, Thrombosis Hemostasis Research Center, Tehran University of Medical Sciences, Tehran, Iran, Iran, Islamic Republic of,
(3) Division of Surgical Oncology, Department of Surgery, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran, Iran, Islamic Republic of,
(4) Cancer Research Center, Department of Pathology, Tehran University of Medical Sciences, Tehran, Iran, Iran, Islamic Republic of,
(5) Hematology and Medical Oncology Department, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran, Iran, Islamic Republic of,
(6) Radiation Oncology Research center, Department of Radiation Oncology, Tehran University of Medical Sciences, Tehran, Iran, Iran, Islamic Republic of,
(7) Medical Imaging Center, ADIR, Cancer Institute, Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran, Iran, Islamic Republic of

Abstract

Background: For many years, the acceptable margins of the resections for ductal carcinoma in situ (DCIS) has been 2 mm, although, in some reports and the recent updates of some guidelines, the closer margins are also declared as acceptable in some circumstances. Despite these new recommendations, the safe margin in DCIS remains a matter of controversy in many institutional and national guidelines.
Case Presentation: A woman with invasive breast cancer with associated DCIS presented to our clinic. She underwent breast-conserving surgery, and pathology report showed one focus of DCIS at a distance of <?1 mm from inked margin. This case was presented in the weekly breast multidisciplinary team session of the Department of Breast Surgery, Tehran University of Medical Sciences.
Question: The question was whether the patient should be operated again to obtain more extensive margins for DCIS or the radiation therapy would be enough as the next step in her treatment.
Conclusion: According to the latest published guidelines, the members of panel decided to accept the margin and informed the patient about the risk of recurrence and the need for adjuvant radiotherapy and follow-up modalities.

References

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Authors

Ahmad Elahi
elahi84@gmail.com (Primary Contact)
Gholamreza Toogeh
Habibollah Mahmoodzadeh
Behnaz Jahanbin
Farhad Shahi
Bita Kalaghchi
Nahid Sedighi
Author Biographies

Ahmad Elahi, Division of Breast Surgical Oncology, Department of Surgery, Alborz University of Medical Sciences, Karaj, Iran

Ahmad Elahi, MD
Address: Imam Ali Hospital Complex, Chamran Blvd,
Azimieh, Karaj, Iran
Tel: +98 26 32527575
Fax: +98 26 32547128
Email: elahi84@gmail.com

Habibollah Mahmoodzadeh, Division of Surgical Oncology, Department of Surgery, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran

 

 

Farhad Shahi, Hematology and Medical Oncology Department, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran

 

 

1.
Elahi A, Toogeh G, Mahmoodzadeh H, Jahanbin B, Shahi F, Kalaghchi B, Sedighi N. Ductal Carcinoma In Situ Close to the Inked Margin: A Case Presented in Multidisciplinary Session With Clinical Discussion and Decision Making. Arch Breast Cancer [Internet]. 2018 Jun. 8 [cited 2025 Jul. 11];:58-62. Available from: https://archbreastcancer.com/index.php/abc/article/view/187

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