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Achieving clear margins. Directed shaving using MarginProbe, as compared to a full cavity shave approach
1University of Iowa Hospital and Clinics, 200 Hawkins Dr., Iowa City, IA 52242, USA.
American Journal of Surgery
|January 5, 2017
Summary
Using MarginProbe for lumpectomy significantly reduced re-excision rates by 57% and tissue removal by 32%. This targeted shaving approach improves outcomes and reduces pathology workload.
Area of Science:
- Surgical Oncology
- Breast Cancer Surgery
- Medical Device Technology
Background:
- Standard lumpectomy often uses full cavity shaving, increasing tissue removal.
- This approach aims to reduce positive margin rates but has drawbacks.
- We investigated a novel intra-operative margin assessment device, MarginProbe.
Purpose of the Study:
- To evaluate the impact of switching from full cavity shaving to a targeted shaving approach using MarginProbe.
- To assess changes in re-excision rates and tissue volume removed during lumpectomy.
Main Methods:
- A retrospective comparison of 137 MarginProbe-guided lumpectomy cases versus 199 standard full cavity shave cases.
- Specimen excision followed standard procedures, with additional shavings based on MarginProbe device readings.
- Intra-operative imaging was utilized as necessary.
Main Results:
- The MarginProbe group showed a 57% reduction in re-excision rates (15.1% to 6.6%, P=0.026).
- Overall tissue volume removed decreased by 32% (115 cc to 78 cc, P=0.0023).
Conclusions:
- MarginProbe facilitated a shift to directed lumpectomy shavings, improving surgical precision.
- This technique significantly decreased re-excision rates and the amount of tissue excised.
- Reduced tissue handling also lessened the burden on pathology services.
