Safety Margin after Neoadjuvant chemotherapy in Breast Cancer: The safe Marginal Zone

The increased use of neoadjuvant chemotherapy has raised the question of the optimal margin to be taken around residual tumor. The question we are trying to answer is whether the margin should be taken according to the original tumor size before chemotherapy or according to the residual tumor after chemotherapy. Surgical and pathological reports for 35 consecutive patients with breast cancer treated by neoadjuvant chemotherapy followed by surgery were collected from the pathology department at kasr Al Ainy hospital and Menofia university hospital. Two patients were excluded from the study as they received preoperative radiotherapy in addition to chemotherapy. All remaining 33 patients received preoperative chemotherapy only. Patients diagnosed with locally advanced breast carcinoma, treated between 2009 and 2010, at kasr Al-Ainy hospital and, department of surgery at Menofia university hospital. Median age of the patients was 51 years. Twenty patients had T2 pathologically (p) (30%) and T3p (30%). The pathological complete remission (pCR) in this subset of patients was only seen in 5 patients. Studying the margin around the tumor showed that 96% (out of 28 patients) of the patients had no microscopic cells at 3 cm distance from the tumor. It seems to be there is no difference between removing the original tumour area versus taking a margin around the remaining tumour only so long the margin is adequate, and not less than 2 cm. Our patient number is still small for a final conclusion in this regards but it may give a highlight on safe breast conservation.