Individualized, patient-centered application of consensus guidelines to improve the quality of breast cancer care

摘要

In this issue of the Red Journal, Moran et al, from the Society of Surgical Oncology and the American Society for Radiation Oncology, present a consensus guideline regarding the management of surgical margins in the context of breast-conserving therapy for early-stage breast cancer (1). This guideline statement has the potential to substantially reduce the number of operations required of patients who pursue breast-conserving therapy, thereby reducing both cost and burden, and perhaps also improving ultimate cosmetic outcomes. Moreover, in an environment of increasing concerns about overuse of mastectomy, this statement may even increase the use of breast-conserving therapy somewhat, given the evidence that certain mastectomy patients initially attempt breast conservation and later receive mastectomy because of margin clearance concerns (2).