Ductal Carcinoma In Situ Close to the Inked Margin: A Case Presented in Multidisciplinary Session With Clinical Discussion and Decision Making

Case Presentation: A woman with invasive breast cancer with associated DCIS presented to our clinic. She underwent breast-conserving surgery, and pathology report showed one focus of DCIS at a distance of < 1 mm from inked margin. This case was presented in the weekly breast multidisciplinary team session of the Department of Breast Surgery, Tehran University of Medical Sciences. Background: For many years, the acceptable margins of the resections for ductal carcinoma in situ (DCIS) has been 2 mm, although, in some reports and the recent updates of some guidelines, the closer margins are also declared as acceptable in some circumstances. Despite these new recommendations, the safe margin in DCIS remains a matter of controversy in many institutional and national guidelines. Question: The question was whether the patient should be operated again to obtain more extensive margins for DCIS or the radiation therapy would be enough as the next step in her treatment. Conclusion: According to the latest published guidelines, the members of panel decided to accept the margin and informed the patient about the risk of recurrence and the need for adjuvant radiotherapy and follow-up modalities.