Cavity shave margins for breast conservative surgery

Background:  20-40% of patients have positive margins after partial mastectomy. Taking additional tissue circumferentially around the cavity left by partial mastectomy "cavity shave margins" may reduce the rate of positive margins. This review aims to evaluate the effect of routine excision of circumferential cavity shave margins after breast-conserving surgery. Methods: This randomized controlled trial had been conducted in General Surgery Department, Sohag Faculty of Medicine from January 2015 to April 2017. 40 patients with early breast cancer were candidates for partial mastectomy and randomly assigned in a 1:1 ratio to have either additional circumferential cavity shave margins or not. Results:  The mean age of both groups were around 39 years (range 30-50 years). More than half of the cases fell in stage I, with a little more than 20% of them were in stage 0 and the rest in stage II at time of operation. Although cavity shave group had longer operative time, longer hospital stay, and higher amount of blood loss; all these showed non-significant difference between the two groups. The mean amount of resected volume was significantly higher among cavity shave group compared to non-cavity shave group. The percentage of positive margin reduced from 40% before shave to only 10% after shave margin. Conclusions:  Cavity shaving resulted in significant reduction of the rates of positive margins and re-operation among patients undergoing breast-conserving surgery.