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Related Experiment Video

Updated: May 2, 2026

Intraoperative Assessment of Resection Margins in Oral Cavity Cancer: This is the Way
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Current options and future perspectives for margin assessment in breast conservation surgery.

Huma Javaid1, Ivan Marin1, Jessica Montalvan1

  • 1Departments of Surgery, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA.

European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
|June 26, 2025
PubMed
Summary

Achieving cancer-free margins in breast conservation surgery (BCS) is crucial. While pathology assessment remains the gold standard, new intraoperative technologies show promise for improving margin assessment and reducing re-excision rates.

Keywords:
Breast cancerIntraoperativeMarginsNegative margins

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Area of Science:

  • Oncology
  • Surgical Pathology
  • Medical Technology

Background:

  • Achieving clear margins in breast conservation surgery (BCS) is vital to prevent re-operations and ensure timely adjuvant therapy.
  • Currently, 20-25% of BCS patients require re-excision due to residual disease, highlighting the need for improved intraoperative margin assessment.
  • Existing methods like frozen sections offer high accuracy but are time-consuming and sample limited areas.

Purpose of the Study:

  • To comprehensively review current and emerging intraoperative margin assessment techniques for breast conservation surgery.
  • To provide surgeons with an overview of available technologies to aid in decision-making during surgery.

Main Methods:

  • A systematic literature review of 40 manuscripts published between January 2009 and December 2022.
  • Evaluation of eight current and ten developing intraoperative margin assessment technologies for BCS using PubMed and Google Scholar.

Main Results:

  • Pathologic evaluation via cytology demonstrated the highest sensitivity (97%) and specificity (99%).
  • Emerging technologies showed variable sensitivity: bioimpedance spectroscopy (13-87%), mass spectrometry (80-100%), optical coherence tomography (93-96%), pharmacology (49.3-98%), and X-ray combined technologies (56-85.6%).

Conclusions:

  • Pathologic assessment remains the benchmark for intraoperative margin evaluation in BCS.
  • While novel technologies show potential, they have not yet replaced traditional methods.
  • Effective intraoperative margin assessment is key to reducing positive margins and re-excision rates in BCS.