However, in many cases, particularly where it is easy to get
good surgical margins around the mass, it is more appropriate to remove the whole lump.
The fact that changes are already present in different regions of the breast could be important in the delivery of radiation therapy or
surgical margin assessment.
If diagnosed early enough for complete surgical excision, surgery alone tends to be curative with
clean surgical margins, given these tumors» low tendency to spread internally.
For complete removal, these need
wide surgical margins, usually including substantial parts of the jawbone.
If surgical margins are clean (tumor - free microscopically), chemotherapy with mitoxantrone or carboplatin (once every 3 weeks for 5 - 6 total treatments post-operatively).
«If we can understand the relationship between what the pathologist sees on a slide under a microscope and what the surgeon is taking out in the operating room, and what accounts for the differences between the two, then we can work backward and figure out how
much surgical margin to take,» he said.
The recommendation for such a tightly
defined surgical margin is the result of a study led by researchers at Perlmutter Cancer Center at NYU Langone Health and published online Oct. 2 in the Journal of the American Academy of Dermatology.
This study will focus on validating this technology for the imaging
of surgical margins of two important canine cancers — mammary tumors and STS.
The findings are important because inaccuracy in feline injection - site
sarcoma surgical margins — the tissue cut out along with the tumor to try to ensure all cancerous cells are removed — can have a negative effect on the patient's health, whether the margin is bigger or smaller than necessary.
The pilot study looked at 35 - to 55 -
millimeter surgical margins from five cats with feline injection site sarcoma, or FISS, and found the greatest margin decreases occurred right after excision.
Understanding how margin length decreases from surgery to pathology — because of how the removed tissue shrinks and tumor cells invade surrounding tissues — can lead to better
surgical margin planning and in turn a better prognosis, said corresponding author Milan Milovancev, a board - certified veterinary surgeon at OSU's College of Veterinary Medicine.
Adjuvant radiation after local excision for mucosal melanoma can be considered, particularly in cases in
which surgical margins may be inadequate due to anatomical constraints, as is common in melanomas that arise in the mucosa of the head and neck.
The biopsy samples from any surgical excision will be sent to a diagnostic laboratory, where skilled veterinary pathologists will examine the samples grossly and then microscopically to determine the exact type of cancer and whether
appropriate surgical margins were obtained.
Researchers at Oregon State University are paving the way for more precision in
determining surgical margins for an aggressive tumor common in cats by analyzing tissue contraction at various stages of the post-operative examination process.
«If we can understand the relationship between what the pathologist sees on a slide under a microscope and what the surgeon is taking out in the operating room, and what accounts for the differences between the two, then we can work backward and figure out how
much surgical margin to take,» says Milan Milovancev, a board - certified veterinary surgeon at the OSU's College of Veterinary Medicine.
«Despite advances during the past years in robotic surgery and precise tissue characterisation, there remains significant challenges in accurately and routinely
defining surgical margins and delivering therapies in a predominantly non-invasive manner, which would reduce patient risk and overall costs.
Emmett points out, «The results of the study show that PSMA PET is more predictive of a treatment response than PSA level,
surgical margins or seminal vesical involvement.»
For example, says Sridharan, after a prostatectomy is performed, the tumor is graded by the pathologist and, in combination with other surgical parameters such as
the surgical margin positivity, whether the cancer has invaded into the lymph nodes, extra-prostatic extensions, and PSA levels, a recurrence risk is assigned.
Biopsy provides a complete picture of tumor type and behavior and allows us to determine if
the surgical margins are clear of cancer cells.
When a focal cancerous mass is removed, the surgeon tries to also remove a small amount of normal tissue around the entire mass of abnormal tissue, in order to achieve what are called «clean
surgical margins.»
Complete local excision with wide
surgical margins is recommended.
Therefore, owner of dogs should be forewarned that clean
surgical margins can never be achieved.
If the biopsy report shows that the tumor is malignant and has invaded into the lymph system or if
the surgical margins were dirty, a second surgery is suggested to get clean margins and the local draining lymph node for biopsy.