Dr. Chagpar on the SHAVE Trial for Breast Cancer

Anees B. Chagpar, MD, MA, MPH, MBA, FRCS(C), FACS, associate professor of surgery (oncology), director, The Breast Center at Smilow Cancer Hospital at Yale-New Haven, assistant director, Global Oncology, Yale Comprehensive Cancer Center, discusses initial results of the SHAVE trial for patients with breast cancer.

The majority of women annually diagnosed with early-stage breast cancer will opt for breast conserving surgery. The objective of this procedure, Chagpar explains, is to ensure that no cancer touches the edge of the specimen. For patients with positive margins, surgeons often remove more tissue during a second surgery. The SHAVE trial examined the efficacy of greater cavity shaving in the first surgery as opposed to a second.

The randomized SHAVE trial permitted surgeons to conduct breast conserving surgery as they normally would. Before closing the procedure, in the operating room, surgeons were randomized to either close the surgery or remove more tissue around the cavity. Results showed that more cavity shaving demonstrated a 50% decrease in reexcision rates and positive margin rates. This did not affect complication rates or patients’ perspective on their cosmetic outcomes, Chagpar says.