When evaluating margin status to consider APBI for early stage invasive breast cancer, given the specification for at least 2 mm margins, do you look at the DCIS margin or only the invasive margin?

I take a slightly different approach. Current guidelines for breast conserving surgery allow for no tumor on ink for invasive cancers, even those with DCIS associated. While ASTRO guidelines recommend 2 mm for APBI (Correa et al., PMID 27866865), other guidelines such as the ABS do not for invasive ...

I would always consider both. DCIS recurrence rates after radiation (NSABP for example) have always been higher than for invasive cancer. Microinvasive cancer will often have recurrence rates similar to DCIS.

Silverstein published his results in his articles and book based on close pathological eval...

Great question! I agree that both Invasive and DCIS margins are important and must be considered. Regarding the more recently published Livi 5 fractioned APBI, personal and institutional eligibility criteria are preferential.

However, anytime I adopt a new protocol for my clinic, I think it is invalu...