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Lumpectomy Specimen Radiography: Does Orientation or 3-Dimensional Tomosynthesis Improve Margin Assessment?
Julia Mario1, Shambhavi Venkataraman2, Valerie Fein-Zachary2
1Harvard Medical School, Boston, Massachusetts, USA.
Summary
Two orthogonal views of breast cancer specimens improved margin assessment over a single view, though not always significantly. Three-dimensional tomosynthesis did not enhance margin assessment compared to 2D mammography.
Area of Science:
- Radiology
- Surgical Pathology
- Medical Imaging
Background:
- Accurate surgical margin assessment is crucial for effective breast cancer treatment.
- Current methods for evaluating excised breast cancer specimens have limitations in precision.
Purpose of the Study:
- To evaluate if two orthogonal views of breast cancer specimens improve surgical margin assessment compared to a single view.
- To determine if 3D tomosynthesis enhances surgical margin assessment over 2D mammography.
Main Methods:
- Forty-one breast cancer specimens were prospectively imaged using four protocols: single 2D view (1VSU), two orthogonal 2D views (2VSU), two orthogonal 2D views on a mammogram unit (2V2DMU), and two orthogonal 3D images (2V3DMU).
- Three breast imagers independently assessed surgical margins for all specimens.
- Histopathology served as the gold standard for margin status.
Main Results:
- The area under the curve (AUC) for diagnostic accuracy was 0.60 (1VSU), 0.66 (2VSU), 0.68 (2V2DMU), and 0.60 (2V3DMU).
- Two orthogonal views (2VSU) showed improved accuracy over a single view (1VSU), with statistical significance for one reader.
- 3D tomosynthesis (2V3DMU) showed mixed results compared to 2D mammography (2V2DMU), with decreased accuracy for two readers.
Conclusions:
- Two orthogonal views of excised breast cancer specimens offer improved accuracy for surgical margin assessment compared to a single view.
- Three-dimensional tomosynthesis does not appear to improve surgical margin assessment compared to standard 2D mammography.
Keywords:
Breast cancer specimenDigital breast tomosynthesisLumpectomy specimen radiographyOrthogonal viewsSurgical marginsMore Related Videos
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