The systematic tumor cavity shaving in different studies its ability to reduce the rate of reexcision in breast conserving surgery helping gain OR time avoiding additionnal surgery
and inducing more cost savings.
It also showed it ability to detect other tumor loci in the remaning bteast.
So why its not mandatory?
Performing a cavity shave margin in patients undergoing a partial mastectomy can somewhat reduce the need for re-excision and the rate of positive margins after surgery. But it does not significantly decrease the re-excision rate but provides wider clear margins in most procedures. It ensures more accurate margin examination and decreases false-positive margin rate, without any increase in removed breast-tissue volume.
Systematic tumour cavity shaving is effective in reducing margin involvement when compared with partial mastectomy alone.And as you mentioned many researches showed that it can also be used as a sample for the remaining breast, helping to detect the residual tumour, and decreasing the rates of local recurrence after BCT. Cavity shaving doesn't seems to be associated with an excessive excised tissue volume or poor cosmetic outcomes also.
But we need more compelling evidences to prove it's effectiveness & advantages before making it as a mandatory procedure.
Its okay Montassar
Things like that happens!
By the way, the research shows that Cavity shaving halved the rates of positive margins and re-excision. Hope one day cavity shaving will become a standard procedure.
Cavity shaving does not significantly decrease the reoperation rate after BCS, but provides wider clear margins and enhances completeness of tumor removal in most procedures compared with lumpectomy alone. It also ensures more accurate margin examination, thus helping to overcome the problem of false-positive lumpectomy margins .
The shave trial showd that " After randomization, patients in the shave group had a significantly lower rate of positive margins than did those in the no-shave group (19% vs. 34%, P=0.01), as well as a lower rate of second surgery for margin clearance (10% vs. 21%, P=0.02). There was no significant difference in complications between the two groups ".
The Cavity shaving also can help detect other tumor loci
residual tumor that is considred by Fisher et al in their article related to the NSABP trial " margin status and occult residual tumor are a critical determinant of local recurrence ".
In our department recently published paper we reported the cases of 75 women with Clear margin and a malignant shave those women were proposed completion mastectomy considering the disease as Bifocal.
65 agreed and in 47,7% of those mastectomies there were residual tumors.
Article Cavity Shaving plus Lumpectomy versus Lumpectomy Alone for P...
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