Breast-conserving treatment is applied when it is determined that negative cut edge pathology has been achieved. Positive margin cases should usually undergo further surgery, or re-excision until a negative margin or mastectomy is obtained. If re-excision is technically possible for breast-conserving treatment, either an excision involving the margins or a complete re-excision of the original excisional cavity may be performed depending on the localization of the initial excisional specimen. Such management may be justified in selected patients with positive microscopic lesion margins for breast-conserving treatment in the absence of an extensive intraductal cancer component (EIC). In these patients, consideration should be given to applying a higher dose of push radiation to the tumor bed. Pusher radiation to the tumor bed is recommended in patients with a higher risk of recurrence. A typical dose is 10-16 Gy 2Gy/fr. Margin evaluation should be performed on all breast-conserving specimens. Ideal margin evaluation requirements include: 1) localization of the surgical specimen; 2) description of the visual and microscopic margin conditions; and 3) documentation of the distance and orientation with respect to the nearest margin and the type of tumor (invasive or intraductal carcinoma in situ). Society for Surgical Oncology-American Society for Radiation Oncology American Society for Radiation Oncology consensus guidelines for breast-conserving surgery combined with whole-breast irradiation margins for stage I and II invasive breast cancer. An extensive intraductal component is defined as an invasive ductal carcinoma in which more than 25% of the tumor volume is intraductal carcinoma in situ and the intraductal carcinoma in situ expands beyond the invasive tumor into the surrounding normal breast parenchyma.