Impact of intraoperative specimen mammography on margins in breast-conserving surgery
- 4 July 2016
- journal article
- Published by Spandidos Publications in Molecular and Clinical Oncology
- Vol. 5 (3), 269-272
- https://doi.org/10.3892/mco.2016.948
Abstract
A positive resection margin is one of the most significant risk factors for local breast cancer recurrence following breast-conserving surgery (BCS). Intraoperative specimen mammography (SMMG) is routinely used to evaluate the surgical margin at our institution. The aim of the present study was to assess the adequacy of SMMG for margin assessment. The patient cohort included 174 women who underwent BCS in 2006. The sensitivity and specificity of SMMG were assessed by comparing the margins assessed by histological and radiological methods. It was also examined whether the rate of positive histological margins was decreased by re-excision following SMMG evaluation. A total of 23 false-negatives and 6 false-positives were determined by SMMG. The sensitivity and specificity of SMMG margin assessment for patients with primary breast cancer were 20.6 and 94.6%, respectively. The positive predictive value was 50% and the negative predictive value was 82.2%. A subgroup analysis revealed that the sensitivity and specificity of SMMG in cases with ductal carcinoma in situ (DCIS) were higher compared with those in invasive ductal carcinoma. Furthermore, the positive histological margin rate was not affected by re-excision. Although the general usefulness of intraoperative SMMG was not proven, this procedure may be useful in specific cases, particularly those with DCIS and those diagnosed by stereotactic biopsy. A prospective study with exact criteria and a standard procedure is required.Keywords
This publication has 21 references indexed in Scilit:
- Society of Surgical Oncology–American Society for Radiation Oncology Consensus Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Stages I and II Invasive Breast CancerJournal of Clinical Oncology, 2014
- Standardized and reproducible methodology for the comprehensive and systematic assessment of surgical resection margins during breast-conserving surgery for invasive breast cancerBMC Cancer, 2009
- The relationship between surgical factors and margin status after breast-conservation surgery for early stage breast cancerThe American Journal of Surgery, 2009
- Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trialsThe Lancet, 2005
- Twenty-Year Follow-up of a Randomized Trial Comparing Total Mastectomy, Lumpectomy, and Lumpectomy plus Irradiation for the Treatment of Invasive Breast CancerNew England Journal of Medicine, 2002
- A new method of margin evaluation in breast conservation surgery using an adjustable mould during fixationHistopathology, 2001
- Long-Term Results of a Randomized Trial Comparing Breast-Conserving Therapy With Mastectomy: European Organization for Research and Treatment of Cancer 10801 TrialJNCI Journal of the National Cancer Institute, 2000
- Outcome at 8 Years After Breast-Conserving Surgery and Radiation Therapy for Invasive Breast Cancer: Influence of Margin Status and Systemic Therapy on Local RecurrenceJournal of Clinical Oncology, 2000
- Conservation approaches for the management of stage I/II carcinoma of the breast: Milan Cancer Institute TrialsWorld Journal of Surgery, 1994
- Factors influencing local relapse and survival and results of salvage treatment after breast-conserving therapy in operable breast cancer: EORTC trial 10801, breast conservation compared with mastectomy in TNM stage I and II breast cancerEuropean Journal Of Cancer, 1992