{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T02:46:17Z","timestamp":1792118777648,"version":"4.4.0"},"reference-count":31,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2014,5,29]],"date-time":"2014-05-29T00:00:00Z","timestamp":1401321600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2014,5,29]],"date-time":"2014-05-29T00:00:00Z","timestamp":1401321600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There remains a controversy in the literature regarding adequate width of negative surgical margins in breast conservative therapy (BCT). It is now advocated that no tumor on an inked margin is a safe negative margin. Majority of studies on the outcomes of BCT had patients with favorable prognostic factors. Pakistani population has a high expression of unfavorable prognostic factors. The objective of this study was to determine a safe negative margin width in Pakistani population that undergoes BCT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 603 patients with identifiable surgical margins underwent BCT from 1997 to 2009\u00a0in Shaukat Khanum Cancer Hospital. Patients were divided into close (\u22642\u00a0mm), free (&gt;2\u201310\u00a0mm), and wide (&gt;10\u00a0mm) margin groups. Locoregional recurrence was defined as recurrence within the operated breast, ipsilateral axilla, or supraclavicular or internal mammary lymph nodes. Locoregional recurrence\u2010free survival was calculated from the date of surgery to the date of locoregional recurrence. Five\u2010year locoregional recurrence\u2010free survival was determined for margin groups. Univariate and multivariate Cox proportional hazard analyses were performed to determine independent predictors of locoregional recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 415 (69 %) patients were &lt;50 years of age. There were 82 (15 %) T3\/T4, 337 (56 %) poorly differentiated, and 238 (39 %) ER\/PR \u2212ve tumors. Nodal positivity was present in 314 (52 %) patients. The actual number of locoregional recurrences was 16 (12 %), 8 (3 %), and 10 (4.6 %), respectively (<jats:italic>P<\/jats:italic> = 0.002). Expected 5\u2010year locoregional recurrence\u2010free survival was 90, 97, and 96 %, respectively (<jats:italic>P<\/jats:italic> = 0.002). On multivariate analysis, tumor size, nodal involvement, and negative margin width were independent predictors of locoregional recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A negative margin width of 2\u00a0mm might represent an adequate negative margin width in the Pakistani population undergoing breast conservative therapy.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-014-2651-7","type":"journal-article","created":{"date-parts":[[2014,5,28]],"date-time":"2014-05-28T19:53:46Z","timestamp":1401306826000},"page":"2863-2870","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Safe Negative Margin Width in Breast Conservative Therapy: Results from a Population with a High Percentage of Negative Prognostic Factors"],"prefix":"10.1002","volume":"38","author":[{"given":"Abu Bakar","family":"Bhatti","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology Shaukat Khanum Memorial Cancer Hospital and Research Center Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amina","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Shaukat Khanum Memorial Cancer Hospital and Research Center Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narjis","family":"Muzaffar","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Shaukat Khanum Memorial Cancer Hospital and Research Center Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neelam","family":"Siddiqui","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Shaukat Khanum Memorial Cancer Hospital and Research Center Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aamir","family":"Syed","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Shaukat Khanum Memorial Cancer Hospital and Research Center Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazhar","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Shaukat Khanum Memorial Cancer Hospital and Research Center Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awais","family":"Aamir","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Shaukat Khanum Memorial Cancer Hospital and Research Center Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arif","family":"Jamshed","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Shaukat Khanum Memorial Cancer Hospital and Research Center Lahore 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