[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-362424-105":59,"doc-detail-362424-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","distant-recurrence-and-margin-involvement-in-invasive-breast-cancer","Distant recurrence and margin involvement in invasive breast cancer","","Clinical studies assess whether involved surgical margins after breast cancer surgery influence distant recurrence (DR) and cancer mortality, because the effect remains uncertain. Analyses used Greater Manchester (GM) and National Cancer Registry (NCRAS) cohorts, measuring margin width and status after curative surgery. Cox proportional hazards models evaluated associations with local recurrence (LR), DR, and breast cancer deaths across BCS and post-BCS chemotherapy settings, then related outcomes to clearance thresholds.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/distant-recurrence-and-margin-involvement-in-invasive-breast-cancer/362424/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/distant-recurrence-and-margin-involvement-in-invasive-breast-cancer/362424.png","ImageObject",300,407,{"name":92,"@type":93},"Jake","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-27","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the study objective regarding surgical margins and outcomes?","Question",{"text":112,"@type":113},"To determine whether margin width or involvement after curative breast cancer surgery is associated with distant recurrence and cancer deaths, and to identify an optimal margin width after breast conservation surgery.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were margin status and width measured in the cohorts?",{"text":117,"@type":113},"Final margin status and exact width (in millimetres) were recorded after surgery, following NHSBSP standards, including any re-excision where applicable.",{"name":119,"@type":110,"acceptedAnswer":120},"What did the results show about involved or narrow margins after breast conservation surgery?",{"text":121,"@type":113},"Involved margins (\u003C1 mm) were associated with higher hazards of distant recurrence and local recurrence after multivariable adjustment in breast conservation surgery patients, and cancer death risk increased in analyses including post-BCS chemotherapy cohorts.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},362424,1790251668,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":44,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},962084928904,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","[www.nature.com/bjc](www.nature.com/bjc British)[ British](www.nature.com/bjc British) Journal of Cancer  \nARTICLE OPEN   \nClinical Studies  \nDistant recurrence and margin involvement in invasive breast cancer  \nSarah Michael 1,2, John Broggio3, Sarah Bowers 1,2, Jane Ooi4, Anne Armstrong 1,5, Mohammed Absar6, Nikitas Dimipoulos2, Simon Ellenbogen7, Jacqui Gath8, Glen Martin1,9 and Nigel James Bundred 1,2 ✉  \n© The Author(s) 2026  \n\n|  | The effect of involved margins after breast cancer surgery on distant recurrence (DR) is unknown. We determined the association between margin width or involvement, DR and cancer deaths.\u003Cbr>PATIENTS AND METHODS: Greater Manchester (GM) and the National Cancer Registry (NCRAS) cohorts were analysed. Margin status after curative surgery was measured. Cox-proportional hazards investigated factors associated with LR, DR and breast cancer deaths.\u003Cbr>RESULTS: In GM (2010–2014), 2295 (70.2%) patients had clear margins ( > 2 mm), 302 (9.2%) close (1–2 mm) and 673 (20.6%) involved ( \u003C 1 mm) margins. 2030 patients underwent breast conservation surgery (BCS) . After multivariable adjustment in BCS patients, involved margins had an increased hazard of DR (HR 1.73, 95% CI:1.03, 2.88, p = 0.037) and LR (HR 2.16, 95% CI:1.31, 3.58, p = 0.003) . NCRAS data from 2010–2013 in 16,420 BCS patients included 3,913 patients (23.9%) with final margins \u003C1 mm. There were 642 deaths (3.9%) after 80.2 months median follow-up: 5.6% in patients with final margins \u003C1 mm and 3.4% with margins >1 mm. After BCS, in 5246 patients who underwent chemotherapy after BCS, involved margins \u003C1 mm had a HR of 1.33 (CI 1.10–1.60, p = 0.003) for cancer death.\u003Cbr>CONCLUSIONS: Margins >1 mm were associated with lower DR and cancer deaths Guidelines should recommend a minimum |  |\n| --- | --- | --- |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n| .\u003Cbr>margin clearance of 1 mm. |  |  |\n|  | British Journal of Cancer (2026) 134:772–780; [https://doi.org/10.1038/s41416-025-03275-z](https://doi.org/10.1038/s41416-025-03275-z) |  |\n|  |  |  |\n\nINTRODUCTION  \nBreast cancer causes 11,400 deaths annually in the UK. Most women with early breast cancer receive conservation surgery (BCS) . If cancer cells remain present at the edges (of the cut) thereis an increased risk of cancer returning at the same site [1, 2] . Previous studies have shown an association between the width of tumour from the margin in colorectal cancer and subsequent outcomes [1, 2] .  \nRemoving cancers without leaving tumour at a surgical margin reduces local recurrence (LR) [3–8] but the effects of margin involvement on distant recurrence (DR) are unclear. How far the tumour should be from the margin is controversial. After BCS, adjuvant treatment including radiotherapy to the breast [3, 7, 9] . and endocrine therapy reduce LR [8, 10, 11] .  \nAmerican Society of Clinical Oncology (ASCO) 2014 guidelines [12], state that negative margins reduced LR but recommended “a margin of no tumour on ink” was sufficient clearance around invasive cancer after BCS [12] . The effect of margin width on DR or breast cancer mortality is unclear [13] .  \nTumour at the margin (ToI) led to an increased risk of DR (HR 1.75 (1.17–2.62)) in two trials [14] . UK Guidelines require a final cancer margin clearance of 1 mm or more [7, 9] but a prospective study POSH found that the 21% of patients left with margins ( \u003C 1 mm) involved, suffered increased DR and worse survival [8] .  \nOur recent metanalysis of margin status after BCS found a 1 mm margin clearance at the edge of a BCS specimen reduced DR and LR [4] . Randomized trials no longer consider women with involved margins as eligible for study participation.  \nIf DR and cancer deaths are associated with involved surgical margins after treatment, changes to current international practice are required. The aim of this study was to use two large UK breast cancer patient data","cbCaihJu6okI53Is","https://ap.wps.com/l/cbCaihJu6okI53Is","pdf",427851,"English","# Introduction\n# Methods\n## Greater Manchester (GM) cohort\n# Results\n# Conclusions","[{\"question\":\"What was the study objective regarding surgical margins and outcomes?\",\"answer\":\"To determine whether margin width or involvement after curative breast cancer surgery is associated with distant recurrence and cancer deaths, and to identify an optimal margin width after breast conservation surgery.\"},{\"question\":\"How were margin status and width measured in the cohorts?\",\"answer\":\"Final margin status and exact width (in millimetres) were recorded after surgery, following NHSBSP standards, including any re-excision where applicable.\"},{\"question\":\"What did the results show about involved or narrow margins after breast conservation surgery?\",\"answer\":\"Involved margins (\\u003c1 mm) were associated with higher hazards of distant recurrence and local recurrence after multivariable adjustment in breast conservation surgery patients, and cancer death risk increased in analyses including post-BCS chemotherapy cohorts.\"}]","Distant recurrence and margin involvement in invasive breast cancer | PDF",1790147646,23]