The CUBE technique: continuous ultrasound-guided breast excision

Area of Science:

• Surgical Oncology
• Medical Imaging
• Breast Surgery

Background:

• Achieving negative margins is crucial in breast-conserving surgery to prevent ipsilateral breast tumor recurrence.
• Current lumpectomy techniques face up to a 40% positive margin rate, increasing recurrence risk.
• A novel approach is needed to enhance margin negativity in lumpectomy specimens.

Purpose of the Study:

• To introduce and evaluate a new ultrasound-guided technique for breast lumpectomy.
• To assess the efficacy of the Continuous Ultrasound-Guided Breast Excision (CUBE) technique in achieving negative margins.

Main Methods:

• A novel partial mastectomy method, Continuous Ultrasound-Guided Breast Excision (CUBE), was developed.
• The CUBE technique utilizes real-time ultrasound for specimen dissection.
• The technique was tested on gel models and then applied to 12 patients with ultrasound-detectable breast lesions.

Main Results:

• All 12 patients undergoing lumpectomy with the CUBE technique achieved negative margins on final pathology.
• Three patients with close margins on ex vivo ultrasound required additional shave margins, which also resulted in negative margins.
• The CUBE technique demonstrated successful real-time margin visualization and adjustment during lumpectomy.

Conclusions:

• The CUBE technique offers continuous margin visualization, enabling real-time adjustments to ensure negative margins.
• Preliminary data suggests the CUBE technique is a promising method for improving margin negativity in breast lumpectomy.
• Further research is warranted to confirm the efficacy and broader applicability of the CUBE technique.