Appropriate margin for lumpectomy excision of invasive breast cancer

The management of patients with early-stage breast cancer has evolved over time, with the understanding that tumor biology, and not just disease burden, impact local control. Local control is greatly improved with systemic therapy, providing an opportunity to decrease the morbidity of local therapy in women with invasive breast cancer. In women undergoing breast-conserving therapy, which consists of lumpectomy and whole-breast irradiation, there has been a lack of consensus as to what constitutes a negative margin. Current evidence indicates that wider margins do not reduce local recurrence compared to “no tumor on ink”. In this article, we will review the available data on the relationship between margin status and local control for invasive breast cancer, and discuss the impact of molecular subtypes and systemic therapy on local control.