Evaluation of Margin Status of a Breast Lumpectomy Specimen: What the Radiologist Should Know

Breast Conserving Therapy (BCS) or lumpectomy has been an established treatment option for women with early-stage invasive breast cancers. Surgical margin status has a significant impact on local recurrence. However, there is much complexity in achieving a negative lumpectomy margin. There are multiple risks and predictors of positive surgical margins that the radiologist needs to be familiar with. When working as a member of a multidisciplinary team, it is important to be cognizant of the pathologist's and surgeon's roles in reducing the number of failed breast conserving surgeries. Despite the common use of imaging to help avoid positive surgical margins, it is important to remember the limitations of standard intraoperative specimen radiographs. A negative resection margin is the goal of BCS ensuring decrease of local recurrence, increased cosmesis, and improved long-term survival.