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Published on: May 20, 2016
A pilot study evaluating shaved cavity margins with micro-computed tomography: a novel method for predicting
Rong Tang1, Suzanne B Coopey, Julliette M Buckley
1Division of Surgical Oncology, Massachusetts General Hospital, Boston, Massachusetts; Division of Breast Surgery, Hunan Provincial Tumor Hospital, The Affiliated Tumor Hospital of Xiangya Medical School of Central South University, China.
Micro-computed tomography (micro-CT) accurately assesses breast cancer lumpectomy margins during surgery. This technology can identify tumor involvement, potentially reducing the need for repeat surgeries.
Area of Science:
- Oncology
- Medical Imaging
- Surgical Pathology
Background:
- Clear lumpectomy margins are crucial for breast conservation to prevent local recurrence.
- 18-50% of lumpectomies require re-excision due to close or positive margins.
- Intraoperative margin assessment is needed to reduce re-excision rates.
Purpose of the Study:
- To evaluate micro-computed tomography (micro-CT) for intraoperative assessment of lumpectomy shaved cavity margins (SCM).
- To determine if micro-CT can rapidly identify tumor involvement at surgical margins.
- To assess the potential of micro-CT to reduce re-excision rates in breast cancer surgery.
Main Methods:
- Twenty-five SCM from six lumpectomies were evaluated using a Skyscan 1173 micro-CT scanner.
- A 7-minute scanning protocol was used to evaluate three SCM simultaneously.
- Micro-CT findings were compared with histopathological results.
Main Results:
- Micro-CT correctly identified margin status in 92% of cases (23/25 SCM).
- The technology demonstrated high accuracy with 83.3% sensitivity and 94.7% specificity.
- Micro-CT showed a positive predictive value of 83.3% and a negative predictive value of 94.7%.
Conclusions:
- Micro-computed tomography is an accurate and promising method for intraoperative margin assessment in breast cancer surgery.
- The short scanning time allows for real-time feedback to surgeons.
- This technology can facilitate immediate, targeted re-excision when necessary.

