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A resection margin or surgical margin is the margin of apparently non-tumorous tissue around a tumor that has been surgically removed, called "resected", in surgical oncology. The resection is an attempt to remove a cancer tumor so that no portion of the malignant growth extends past the edges or margin of the removed tumor and surrounding tissue.
Cases in which a lung tumor invades the chest wall and an en bloc resection of ribs must be performed to achieve negative resection margins generally are felt to abrogate the value of VATS. Also pneumonectomy by VATS is a safe and feasible treatment for both benign and malignant lung diseases that induces acceptable damage and has lower morbidity.
Complete circumferential peripheral and deep margin assessment (CCPDMA) is the preferred method for the removal of certain cancers, especially skin cancers. [ 1 ] [ 2 ] There are two forms of CCPDMA surgery: Mohs surgery and surgical excision coupled with margin assessment.
Mohs surgery is the gold standard method for obtaining complete margin control during removal of a skin cancer (complete circumferential peripheral and deep margin assessment - CCPDMA) using frozen section histology. [1] CCPDMA or Mohs surgery allows for the removal of a skin cancer with very narrow surgical margin and a high cure rate.
The frozen section procedure as practiced today in medical laboratories is based on the description by Dr Louis B. Wilson in 1905. Wilson developed the technique from earlier reports at the request of Dr William Mayo, surgeon and one of the founders of the Mayo Clinic [3] Earlier reports by Dr Thomas S. Cullen at Johns Hopkins Hospital in Baltimore also involved frozen section, but only after ...
A pathologist analyzes the margin excised by the lumpectomy to detect any possible cancer cells. A cancerous margin is "positive", while a healthy margin is "clean" or "negative". A re-excision lumpectomy is performed if the margin is detected to be positive or cancerous cells are very close to the margin. [9]
Biopsies are also used to diagnose diseases other than cancer, including inflammatory, infectious, or idiopathic diseases of the skin and gastrointestinal tract, to name only a few. Surgical resection specimens are obtained by the therapeutic surgical removal of an entire diseased area or organ (and occasionally multiple organs).
[2] Breast-conserving surgery may also be used in cases of biopsy-proven invasive breast cancer or biopsy-proven ductal carcinoma in situ. In the assessment of the tumor, the surgeon should assess the ability to resect the tumor with clear margins while providing a cosmetic result that is acceptable to the patient. [3]