Karabacak U., Derebey M., Tarim I. A., Yuruker S. S., Gungor B. B., Kamali Polat A.
MEDICINA (KAUNAS, LITHUANIA), cilt.62, sa.6, ss.1-11, 2026 (SCI-Expanded, Scopus)
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Yayın Türü:
Makale / Tam Makale
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Cilt numarası:
62
Sayı:
6
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Basım Tarihi:
2026
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Doi Numarası:
10.3390/medicina62061061
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Dergi Adı:
MEDICINA (KAUNAS, LITHUANIA)
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Derginin Tarandığı İndeksler:
Scopus, Science Citation Index Expanded (SCI-EXPANDED), Directory of Open Access Journals
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Sayfa Sayıları:
ss.1-11
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Ondokuz Mayıs Üniversitesi Adresli:
Evet
Özet
Background/Objectives: The optimal surgical margin width after breast-conserving surgery (BCS) for pure ductal carcinoma in situ (DCIS) remains controversial; although current guidelines consider a surgical margin of ≥2 mm sufficient, the clinical safety of narrower margins is unclear. This study aimed to evaluate the association between surgical margin width and ipsilateral breast tumor recurrence (IBTR), with a focus on the 1 mm threshold. Materials and Methods: In this retrospective single-center cohort study, 107 patients with pure DCIS treated with BCS followed by adjuvant radiotherapy (RT) between 1 January 2009 and 1 January 2025 were analyzed. Final surgical margins were categorized as <1 mm, 1–2 mm, and ≥2 mm. The primary endpoint was IBTR. Kaplan–Meier analysis was performed. Results: The median age of the study population was 52 years (IQR: 46–61). High-grade DCIS was present in 48 patients (44.9%), comedo necrosis in 68 (63.6%), and estrogen receptor positivity in 87 (81.3%). Overall, 10 patients (9.3%) underwent re-excision for margin widening. Final surgical margin widths were <1 mm in 36 patients (34%), 1–2 mm in 18 (17%), and ≥2 mm in 53 (49%). IBTR occurred in seven patients (6.5%) during a median follow-up of 48 months (range, 12–217 months), with a median time to recurrence of 33 months. Kaplan–Meier analysis showed no significant difference in recurrence-free survival according to a 2 mm margin threshold, whereas margins < 1 mm were associated with significantly worse outcomes (p = 0.002). Conclusions: Margins < 1 mm were associated with increased IBTR risk, whereas margins < 2 mm did not appear to confer uniform risk. These findings suggest that margin widths between 1 and 2 mm may represent a heterogeneous group, and clinical decision-making in this range should be individualized. However, further studies are needed to validate these outcomes.