Mastectomy scar

[jb2]

Is there any data for how much margin is needed around the mastectomy scar? How much margin do you all use?

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[Reaganite]

Is there any data for how much margin is needed around the mastectomy scar? How much margin do you all use?

We've had this discussion on here before. No hard data to guide margins or whether you should do it all. I actually did a little experiment and fused several pre-chemo/mastectomy scans to the patients' planning CT scans and found the scar often bore no relationship to where the tumor was. So what exactly am I boosting? I've personally stopped doing it except in inflammatory cases since I think the skin immediately outside the scar is at risk. If I have close or positive margins on a non-inflammatory case, I fuse the pre-chemo/mastectomy scan and try to boost where the tumor actually was.

 

[seper]

I still cover entire scar (given classic data). No margin beyond actual scar is often feasible, since opposite breast and posterior axilla would then be included.

 

[Pewl]

Institutionally we did a 2cm margin boost around the scar with electrons. My understanding is that the scar is still the most common site of recurrence, but I agree I'm not sure what it is we're boosting! Scar boosting is just extrapolated from lumpectomy boost data, right?

 

[Reaganite]

http://forums.studentdoctor.net/threads/post-mastectomy-boost.768838/