Intraoperative radiological margin assessment in breast-conserving surgery

Area of Science:

• Surgical Oncology
• Radiology
• Breast Cancer Management

Background:

• Accurate margin assessment is critical in breast-conserving surgery to minimize recurrence.
• Intraoperative margin evaluation can reduce reoperation rates.
• Traditional margin assessment relies on final histology, delaying results.

Purpose of the Study:

• To evaluate the accuracy of intraoperative specimen radiography (IOSR) for margin assessment in breast-conserving surgery.
• To determine the potential impact of IOSR on achieving negative margins.
• To assess the time and economic implications of using IOSR.

Main Methods:

• A prospective study included 170 patients with visible lesions on preoperative mammograms.
• Intraoperative X-ray of lumpectomy specimens was performed for margin assessment.
• Final histological data were collected to compare with IOSR findings.

Main Results:

• IOSR enabled margin status evaluation in 91.2% of specimens (155 cases).
• If margin assessment relied solely on IOSR, the positive margin rate would have been 6.5%.
• The study suggests negative margins could have been achieved in 93.5% of cases using IOSR.

Conclusions:

• Intraoperative specimen radiography is an accurate tool for margin assessment in breast-conserving surgery.
• Utilizing IOSR can significantly increase the rate of achieving negative surgical margins.
• This technique offers potential time savings and substantial economic benefits in breast cancer treatment.