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Published on: May 10, 2021
Resection margins in ultrasound-guided breast-conserving surgery
Oded Olsha1, David Shemesh, Moshe Carmon
1Department of Surgery, Shaare Zedek Medical Center, Jerusalem, Israel. oolsha@gmail.com
Annals of Surgical Oncology
|August 25, 2010
Summary
Intraoperative ultrasound helps surgeons achieve clear margins during breast-conserving surgery, reducing reoperations. Ultrasound margins under 0.5 cm indicate a need for re-excision, especially in multifocal tumors.
Area of Science:
- Oncology
- Surgical Oncology
- Medical Imaging
Background:
- Breast-conserving surgery (BCS) aims to remove breast cancer while preserving the breast.
- Achieving adequate surgical margins is crucial to minimize local recurrence.
- Intraoperative ultrasound (IOUS) is explored as a tool to guide margin assessment during BCS.
Purpose of the Study:
- To quantify intraoperative ultrasound (IOUS) margin size in breast cancer.
- To assess the relationship between IOUS margins and tumor characteristics.
- To evaluate the impact of IOUS on reoperation rates in BCS.
Main Methods:
- Prospective recording of IOUS margin measurements in patients undergoing BCS.
- Comparison of IOUS margins with final pathology margin assessments.
- Analysis of factors influencing margin accuracy, including tumor size, multifocality, and histology.
Main Results:
- A good correlation was found between IOUS and pathology margins (r = 0.4674, P < 0.0008).
- IOUS margins ≥0.5 cm predicted adequate pathology margins (≥0.2 cm) in 95% of cases.
- Multifocality significantly affected ultrasound's overestimation of pathology margins (P = 0.0473).
Conclusions:
- Intraoperative ultrasound (IOUS) can help reduce reoperation rates after BCS.
- Re-excision of ultrasound margins <0.5 cm is recommended intraoperatively.
- The reliability of IOUS in predicting closest pathology margins is reduced in multifocal breast tumors.
