GuidelineJournal of clinical oncology : official journal of the American Society of Clinical Oncology2016
Society of Surgical Oncology-American Society for Radiation Oncology-American Society of Clinical Oncology Consensus Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Ductal Carcinoma In Situ.
Abstract readMeta-AnalysisPractice GuidelineSystematic Review
In one paragraph
Guideline in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 115 papers, 3 of them syntheses that pooled it.
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115citing papers in PubMed, 3 pooled it
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Who cites it
115 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Margin status, re-excision, and completion mastectomy after oncoplastic versus conventional breast-conserving surgery for breast cancer: a systematic review and meta-analysis.Frontiers in oncology · 2026Pooled it
- Impact of intraoperative margin optimization strategies compared to standard breast-conserving surgery on oncologic outcomes: a systematic review and meta-analysis of randomized and prospective trials.World journal of surgical oncology · 2025Pooled it
- Local recurrence and residual tumor rates following cryoablation for small early-stage breast cancers: systemic review and meta-analysis.Breast cancer (Tokyo, Japan) · 2025Pooled it
- Lumpectomy Margins and Local Recurrence in DCIS: Results From the NRG Oncology/NSABP B-35 Randomized Clinical Trial.JAMA surgery · 2026Trial
- Surgical outcomes after radioactive 125I seed versus hookwire localization of non-palpable breast cancer: a multicentre randomized clinical trial.The British journal of surgery · 2021Trial
- Multidisciplinary Intraoperative Assessment of Breast Specimens Reduces Number of Positive Margins.Annals of surgical oncology · 2018Trial
- Letter to the Editor: Bridging the surgical benefit-survival paradox of preoperative MRI in DCIS.European radiology · 2026Article
- Intraoperative NIR-II fluorescence guidance for precise tumor margin assessment and maximized tissue preservation in breast surgery.Breast cancer research : BCR · 2026Article
- Intraoperative measurement of breast-conserving surgery margins: surgical application.Breast cancer research : BCR · 2026Review
- Recurrence Patterns and Overtreatment in Pure DCIS: A Retrospective Clinical and Radiological Follow-Up Study.Journal of personalized medicine · 2026Article
- Breast Cancer Surgery: Past, Present and Future-A Narrative Review.Journal of clinical medicine · 2026Review
- Impact of Cavity Shaving on Margin Status and Re-excision Rates in Breast-Conserving Surgery: Experience from a Single Institute.Archives of breast cancer · 2026Article
- Endoscopic nipple-sparing mastectomy with immediate DIEP flap reconstruction following neoadjuvant chemotherapy for multifocal HER2-positive breast cancer: a case report.Journal of surgical case reports · 2026Article
- Association between molecular subtypes of breast cancer and surgical margin status analysis from Assam, India.Discover oncology · 2026Article
- From overtreatment to precision: a new clinical standard for DCIS management.Cancer biology & medicine · 2026Article
- Cause-specific mortality after a diagnosis of ductal carcinoma in situ: Associations with screening and socio-economic status.International journal of cancer · 2026Article
- Photoacoustic imaging: An emerging tool for intraoperative margin assessment in breast-conserving surgery.Photoacoustics · 2026Review
- Intraoperative specimen ultrasonography as a tool for real-time margin assessment in breast-conserving surgery.Frontiers in oncology · 2026Article
- Current practices and challenges in margin evaluation for breast-conserving surgery specimens: a nationwide survey in Japan with international benchmarking.Breast cancer (Tokyo, Japan) · 2026Article
- Refining Sentinel Lymph Node Biopsy Decisions for Clinically Node-Negative Microinvasive DCIS.The breast journal · 2026Article
55 more citing papers are in PubMed but not listed here.
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Authors and funding
13 authors.
Monica MorrowMonica Morrow and Kimberly J. Van Zee, Breast Service, Memorial Sloan Kettering Cancer Center, New York, NY; Lawrence J. Solin, Albert Einstein Healthcare Network, Philadelphia, PA; Mariana Chavez-MacGregor, University of Texas MD Anderson Cancer Center, Houston, TX; Jay R. Harris and Stuart J. Schnitt, Harvard Medical School, Boston, MA; Janet Horton and Shelley Hwang, Duke University Medical Center, Durham, NC; Peggy L. Johnson, Advocate in Science, Susan G. Komen, Kansas City, KS; Irene Wapnir, Stanford University School of Medicine, Stanford, CA; Meena S. Moran, Yale School of Medicine, Yale University, New Haven, CT; and Nehmat Houssami and M. Luke Marinovich, Screening and Test Evaluation Program (STEP), Sydney School of Public Health, Sydney Medical School, The University of Sydney, New South Wales, Australia.
Kimberly J Van ZeeMonica Morrow and Kimberly J. Van Zee, Breast Service, Memorial Sloan Kettering Cancer Center, New York, NY; Lawrence J. Solin, Albert Einstein Healthcare Network, Philadelphia, PA; Mariana Chavez-MacGregor, University of Texas MD Anderson Cancer Center, Houston, TX; Jay R. Harris and Stuart J. Schnitt, Harvard Medical School, Boston, MA; Janet Horton and Shelley Hwang, Duke University Medical Center, Durham, NC; Peggy L. Johnson, Advocate in Science, Susan G. Komen, Kansas City, KS; Irene Wapnir, Stanford University School of Medicine, Stanford, CA; Meena S. Moran, Yale School of Medicine, Yale University, New Haven, CT; and Nehmat Houssami and M. Luke Marinovich, Screening and Test Evaluation Program (STEP), Sydney School of Public Health, Sydney Medical School, The University of Sydney, New South Wales, Australia.
Lawrence J SolinMonica Morrow and Kimberly J. Van Zee, Breast Service, Memorial Sloan Kettering Cancer Center, New York, NY; Lawrence J. Solin, Albert Einstein Healthcare Network, Philadelphia, PA; Mariana Chavez-MacGregor, University of Texas MD Anderson Cancer Center, Houston, TX; Jay R. Harris and Stuart J. Schnitt, Harvard Medical School, Boston, MA; Janet Horton and Shelley Hwang, Duke University Medical Center, Durham, NC; Peggy L. Johnson, Advocate in Science, Susan G. Komen, Kansas City, KS; Irene Wapnir, Stanford University School of Medicine, Stanford, CA; Meena S. Moran, Yale School of Medicine, Yale University, New Haven, CT; and Nehmat Houssami and M. Luke Marinovich, Screening and Test Evaluation Program (STEP), Sydney School of Public Health, Sydney Medical School, The University of Sydney, New South Wales, Australia.
Nehmat HoussamiMonica Morrow and Kimberly J. Van Zee, Breast Service, Memorial Sloan Kettering Cancer Center, New York, NY; Lawrence J. Solin, Albert Einstein Healthcare Network, Philadelphia, PA; Mariana Chavez-MacGregor, University of Texas MD Anderson Cancer Center, Houston, TX; Jay R. Harris and Stuart J. Schnitt, Harvard Medical School, Boston, MA; Janet Horton and Shelley Hwang, Duke University Medical Center, Durham, NC; Peggy L. Johnson, Advocate in Science, Susan G. Komen, Kansas City, KS; Irene Wapnir, Stanford University School of Medicine, Stanford, CA; Meena S. Moran, Yale School of Medicine, Yale University, New Haven, CT; and Nehmat Houssami and M. Luke Marinovich, Screening and Test Evaluation Program (STEP), Sydney School of Public Health, Sydney Medical School, The University of Sydney, New South Wales, Australia.
Mariana Chavez-MacGregorMonica Morrow and Kimberly J. Van Zee, Breast Service, Memorial Sloan Kettering Cancer Center, New York, NY; Lawrence J. Solin, Albert Einstein Healthcare Network, Philadelphia, PA; Mariana Chavez-MacGregor, University of Texas MD Anderson Cancer Center, Houston, TX; Jay R. Harris and Stuart J. Schnitt, Harvard Medical School, Boston, MA; Janet Horton and Shelley Hwang, Duke University Medical Center, Durham, NC; Peggy L. Johnson, Advocate in Science, Susan G. Komen, Kansas City, KS; Irene Wapnir, Stanford University School of Medicine, Stanford, CA; Meena S. Moran, Yale School of Medicine, Yale University, New Haven, CT; and Nehmat Houssami and M. Luke Marinovich, Screening and Test Evaluation Program (STEP), Sydney School of Public Health, Sydney Medical School, The University of Sydney, New South Wales, Australia.
Jay R HarrisMonica Morrow and Kimberly J. Van Zee, Breast Service, Memorial Sloan Kettering Cancer Center, New York, NY; Lawrence J. Solin, Albert Einstein Healthcare Network, Philadelphia, PA; Mariana Chavez-MacGregor, University of Texas MD Anderson Cancer Center, Houston, TX; Jay R. Harris and Stuart J. Schnitt, Harvard Medical School, Boston, MA; Janet Horton and Shelley Hwang, Duke University Medical Center, Durham, NC; Peggy L. Johnson, Advocate in Science, Susan G. Komen, Kansas City, KS; Irene Wapnir, Stanford University School of Medicine, Stanford, CA; Meena S. Moran, Yale School of Medicine, Yale University, New Haven, CT; and Nehmat Houssami and M. Luke Marinovich, Screening and Test Evaluation Program (STEP), Sydney School of Public Health, Sydney Medical School, The University of Sydney, New South Wales, Australia.
Janet HortonMonica Morrow and Kimberly J. Van Zee, Breast Service, Memorial Sloan Kettering Cancer Center, New York, NY; Lawrence J. Solin, Albert Einstein Healthcare Network, Philadelphia, PA; Mariana Chavez-MacGregor, University of Texas MD Anderson Cancer Center, Houston, TX; Jay R. Harris and Stuart J. Schnitt, Harvard Medical School, Boston, MA; Janet Horton and Shelley Hwang, Duke University Medical Center, Durham, NC; Peggy L. Johnson, Advocate in Science, Susan G. Komen, Kansas City, KS; Irene Wapnir, Stanford University School of Medicine, Stanford, CA; Meena S. Moran, Yale School of Medicine, Yale University, New Haven, CT; and Nehmat Houssami and M. Luke Marinovich, Screening and Test Evaluation Program (STEP), Sydney School of Public Health, Sydney Medical School, The University of Sydney, New South Wales, Australia.
Shelley HwangMonica Morrow and Kimberly J. Van Zee, Breast Service, Memorial Sloan Kettering Cancer Center, New York, NY; Lawrence J. Solin, Albert Einstein Healthcare Network, Philadelphia, PA; Mariana Chavez-MacGregor, University of Texas MD Anderson Cancer Center, Houston, TX; Jay R. Harris and Stuart J. Schnitt, Harvard Medical School, Boston, MA; Janet Horton and Shelley Hwang, Duke University Medical Center, Durham, NC; Peggy L. Johnson, Advocate in Science, Susan G. Komen, Kansas City, KS; Irene Wapnir, Stanford University School of Medicine, Stanford, CA; Meena S. Moran, Yale School of Medicine, Yale University, New Haven, CT; and Nehmat Houssami and M. Luke Marinovich, Screening and Test Evaluation Program (STEP), Sydney School of Public Health, Sydney Medical School, The University of Sydney, New South Wales, Australia.
Peggy L JohnsonMonica Morrow and Kimberly J. Van Zee, Breast Service, Memorial Sloan Kettering Cancer Center, New York, NY; Lawrence J. Solin, Albert Einstein Healthcare Network, Philadelphia, PA; Mariana Chavez-MacGregor, University of Texas MD Anderson Cancer Center, Houston, TX; Jay R. Harris and Stuart J. Schnitt, Harvard Medical School, Boston, MA; Janet Horton and Shelley Hwang, Duke University Medical Center, Durham, NC; Peggy L. Johnson, Advocate in Science, Susan G. Komen, Kansas City, KS; Irene Wapnir, Stanford University School of Medicine, Stanford, CA; Meena S. Moran, Yale School of Medicine, Yale University, New Haven, CT; and Nehmat Houssami and M. Luke Marinovich, Screening and Test Evaluation Program (STEP), Sydney School of Public Health, Sydney Medical School, The University of Sydney, New South Wales, Australia.
M Luke MarinovichMonica Morrow and Kimberly J. Van Zee, Breast Service, Memorial Sloan Kettering Cancer Center, New York, NY; Lawrence J. Solin, Albert Einstein Healthcare Network, Philadelphia, PA; Mariana Chavez-MacGregor, University of Texas MD Anderson Cancer Center, Houston, TX; Jay R. Harris and Stuart J. Schnitt, Harvard Medical School, Boston, MA; Janet Horton and Shelley Hwang, Duke University Medical Center, Durham, NC; Peggy L. Johnson, Advocate in Science, Susan G. Komen, Kansas City, KS; Irene Wapnir, Stanford University School of Medicine, Stanford, CA; Meena S. Moran, Yale School of Medicine, Yale University, New Haven, CT; and Nehmat Houssami and M. Luke Marinovich, Screening and Test Evaluation Program (STEP), Sydney School of Public Health, Sydney Medical School, The University of Sydney, New South Wales, Australia.
Stuart J SchnittMonica Morrow and Kimberly J. Van Zee, Breast Service, Memorial Sloan Kettering Cancer Center, New York, NY; Lawrence J. Solin, Albert Einstein Healthcare Network, Philadelphia, PA; Mariana Chavez-MacGregor, University of Texas MD Anderson Cancer Center, Houston, TX; Jay R. Harris and Stuart J. Schnitt, Harvard Medical School, Boston, MA; Janet Horton and Shelley Hwang, Duke University Medical Center, Durham, NC; Peggy L. Johnson, Advocate in Science, Susan G. Komen, Kansas City, KS; Irene Wapnir, Stanford University School of Medicine, Stanford, CA; Meena S. Moran, Yale School of Medicine, Yale University, New Haven, CT; and Nehmat Houssami and M. Luke Marinovich, Screening and Test Evaluation Program (STEP), Sydney School of Public Health, Sydney Medical School, The University of Sydney, New South Wales, Australia.
Irene WapnirMonica Morrow and Kimberly J. Van Zee, Breast Service, Memorial Sloan Kettering Cancer Center, New York, NY; Lawrence J. Solin, Albert Einstein Healthcare Network, Philadelphia, PA; Mariana Chavez-MacGregor, University of Texas MD Anderson Cancer Center, Houston, TX; Jay R. Harris and Stuart J. Schnitt, Harvard Medical School, Boston, MA; Janet Horton and Shelley Hwang, Duke University Medical Center, Durham, NC; Peggy L. Johnson, Advocate in Science, Susan G. Komen, Kansas City, KS; Irene Wapnir, Stanford University School of Medicine, Stanford, CA; Meena S. Moran, Yale School of Medicine, Yale University, New Haven, CT; and Nehmat Houssami and M. Luke Marinovich, Screening and Test Evaluation Program (STEP), Sydney School of Public Health, Sydney Medical School, The University of Sydney, New South Wales, Australia.
Meena S MoranMonica Morrow and Kimberly J. Van Zee, Breast Service, Memorial Sloan Kettering Cancer Center, New York, NY; Lawrence J. Solin, Albert Einstein Healthcare Network, Philadelphia, PA; Mariana Chavez-MacGregor, University of Texas MD Anderson Cancer Center, Houston, TX; Jay R. Harris and Stuart J. Schnitt, Harvard Medical School, Boston, MA; Janet Horton and Shelley Hwang, Duke University Medical Center, Durham, NC; Peggy L. Johnson, Advocate in Science, Susan G. Komen, Kansas City, KS; Irene Wapnir, Stanford University School of Medicine, Stanford, CA; Meena S. Moran, Yale School of Medicine, Yale University, New Haven, CT; and Nehmat Houssami and M. Luke Marinovich, Screening and Test Evaluation Program (STEP), Sydney School of Public Health, Sydney Medical School, The University of Sydney, New South Wales, Australia.
Funding
X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Hongbiao Carl Lekaye · 1985 to 2026
$347.4MNCI NIH HHS P30 CA008748
Abstract
Background Controversy exists regarding the optimal negative margin width for ductal carcinoma in situ (DCIS) treated with breast-conserving surgery and whole-breast irradiation (WBRT). Methods A multidisciplinary consensus panel used a meta-analysis of margin width and ipsilateral breast tumor recurrence (IBTR) from a systematic review of 20 studies including 7883 patients and other published literature as the evidence base for consensus. Results Negative margins halve the risk of IBTR compared with positive margins defined as ink on DCIS. A 2 mm margin minimizes the risk of IBTR compared with smaller negative margins. More widely clear margins do not significantly decrease IBTR compared with 2 mm margins. Negative margins less than 2 mm alone are not an indication for mastectomy, and factors known to impact rates of IBTR should be considered in determining the need for re-excision. Conclusion The use of a 2 mm margin as the standard for an adequate margin in DCIS treated with WBRT is associated with low rates of IBTR and has the potential to decrease re-excision rates, improve cosmetic outcome, and decrease health care costs. Clinical judgment should be used in determining the need for further surgery in patients with negative margins < 2 mm.
Indexed as
Breast NeoplasmsCarcinoma, Intraductal, NoninfiltratingConsensus Statements as TopicFemaleHumansMastectomy, SegmentalMiddle AgedNeoplasm Recurrence, LocalSocieties, MedicalSurgical OncologyUnited States
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