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Intraoperative margin assessment and re-excision rate in breast conserving surgery
F J Fleming1, A D K Hill, E W Mc Dermott
1Department of Surgery, St Vincent's University Hospital, University College Dublin, Elm Park, Dublin 4, Ireland.
Summary
Intraoperative margin assessment effectively reduces reoperations in breast cancer conserving surgery. This method helps surgeons achieve clear margins, improving patient outcomes and minimizing the need for additional procedures.
Area of Science:
- Oncology
- Surgical Pathology
- Breast Surgery
Background:
- Achieving clear margins is crucial in breast cancer conserving surgery to minimize local recurrence.
- Intraoperative margin assessment can potentially improve the accuracy of tumor excision during surgery.
Purpose of the Study:
- To evaluate the effectiveness of intraoperative margin assessment in achieving clear margins during breast cancer conserving surgery.
Main Methods:
- Two hundred and twenty patients undergoing wide local excision (WLE) for invasive breast cancer were included.
- Pathologists macroscopically estimated tumor-margin distance intraoperatively and communicated findings to surgeons.
- Margins with a distance <10 mm were considered compromised and re-excised if feasible.
Main Results:
- 37% of patients required margin re-excision based on intraoperative assessment.
- Only 20% of re-excised margins were found to be compromised upon final microscopic examination.
- Intraoperative assessment reduced the need for a second operation from 21.4% to 9.1%.
Conclusions:
- Intraoperative macroscopic margin assessment is an effective strategy.
- This technique significantly reduces the number of patients requiring a second operation for clear margins in breast cancer surgery.