Surgical Management of Solid Papillary Carcinoma of the Breast with Evidence of Invasion
Clinical Scenario
Solid papillary carcinoma of the breast with evidence of invasion is an operable breast malignancy requiring both
local tumour control and accurate axillary staging. The surgical approach is tailored to tumour size and the extent
of lymph node involvement.
Treatment Approach
Surgical intervention is the cornerstone of management, with the choice of procedure guided by tumour dimensions and
breast characteristics. Axillary surgery is undertaken in all patients to stage the axilla, with the specific
technique determined by preoperative assessment findings.
Full procedural selection criteria and sequencing available in the complete protocol.
Treatment Goal
Achieving adequate surgical margins is the primary measurable objective.
Clear radial resection margin ≥ 1 mm
References
- Surgical treatment for breast cancer may consist of an excision of the tumour with surrounding normal breast tissue (breast conserving surgery) or mastectomy.
- Axillary surgery should be performed in all patients with invasive breast cancer in order to stage the axilla and eradicate metastatic disease within the nodes.
- Sentinel lymph node biopsy (SLNB) is the axillary staging procedure of choice.
- Patients shown to have axillary node metastases on preoperative axillary ultrasound and FNA should proceed directly to an axillary node clearance.
- Patients with a margin of less than 1 mm should be offered re-excision.
- A 1 mm margin is acceptable and this is the minimal margin that will be accepted in all patients undergoing breast conserving surgery.
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