What question did this study set out to answer?

To understand how margin involvement after breast cancer surgery affects distant recurrence and cancer deaths.

January 6, 2026Open Access

Distant recurrence and margin involvement in invasive breast cancer

Key Points

To understand how margin involvement after breast cancer surgery affects distant recurrence and cancer deaths.
Analyzed cohorts from Greater Manchester and National Cancer Registry.
Measured margin status post-curative surgery.
Used Cox-proportional hazards to assess factors associated with distant recurrence and cancer deaths.
Involved margins (<1 mm) increased hazard of distant recurrence (HR 1.73) and local recurrence (HR 2.16).
In 16,420 patients, 3.9% died after a median follow-up of 80.2 months, with higher mortality in those with margins <1 mm.
Guidelines recommend a minimum margin clearance of 1 mm to reduce risk of distant recurrence.

Abstract

Abstract 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. 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. 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 ( 1 mm. After BCS, in 5246 patients who underwent chemotherapy after BCS, involved margins 1 mm were associated with lower DR and cancer deaths. Guidelines should recommend a minimum margin clearance of 1 mm.

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