Accuracy of Specimen Radiography in Assessing Complete Local Excision with Breast-Conservation Surgery

Area of Science:

• Radiology
• Oncology
• Surgical Pathology

Background:

• Complete local excision (CLE) is crucial for breast-conserving surgery outcomes.
• Accurate assessment of surgical margins is essential to prevent local recurrence.
• Radiography of resected specimens offers a potential method for intraoperative margin assessment.

Purpose of the Study:

• To evaluate the diagnostic accuracy of specimen radiography in assessing CLE.
• To identify radiographic features associated with successful local excision of breast cancer.

Main Methods:

• Retrospective cross-sectional study of female breast cancer cases undergoing breast-conserving surgery.
• Analysis of specimen radiographs for features: margin spiculation, mass presence/absence, microcalcification presence/proximity, mass size.
• Exclusion criteria included male patients, mammographically invisible disease, benign/inconclusive pathology, mastectomy, and dense breast parenchyma.

Main Results:

• Absence of adjacent microcalcification and presence of a mass on radiographs were significantly associated with CLE.
• Specimen radiography demonstrated a positive predictive value of 83.3%, sensitivity of 80.7%, and specificity of 81% for predicting CLE.
• Other evaluated features showed no significant association with CLE.

Conclusions:

• Specimen radiography is a valuable and sensitive tool for predicting complete local excision in breast cancer.
• Radiographic assessment of resected specimens can aid in confirming adequate margins.
• This technique supports surgical decision-making and can potentially reduce positive margin rates.