Confocal Microscopy for Intraoperative Margin Assessment of Lumpectomies by Surgeons in Breast Cancer: Training,...

Area of Science:

• Oncology
• Surgical Pathology
• Medical Devices

Background:

• Breast-conserving surgery (BCS) aims for tumor removal while preserving breast tissue.
• Clear margins are critical in BCS to reduce re-excision and recurrence.
• Real-time intraoperative margin assessment is needed to improve BCS outcomes.

Purpose of the Study:

• To describe surgeon training and integration of the Histolog Scanner (HS) into clinical practice.
• To evaluate the impact of HS on surgical outcomes, specifically re-excision rates.
• To assess the diagnostic performance of HS for intraoperative margin assessment in BCS.

Main Methods:

• One surgeon completed a 6-hour online training program on HS image interpretation.
• The HS was integrated into the surgical workflow for intraoperative margin assessment.
• A retrospective analysis of 68 BCS patients using HS for margin assessment was conducted.

Main Results:

• The surgeon achieved high diagnostic accuracy with HS: 100% sensitivity, 96.3% specificity, 96.9% accuracy.
• Positive predictive value (PPV) was 85.7% and negative predictive value (NPV) was 100%.
• Intraoperative HS use resulted in zero re-excision cases among the studied patients.

Conclusions:

• The Histolog Scanner facilitates accurate intraoperative margin assessment in BCS.
• Integrating HS into routine practice significantly reduces re-excision rates.
• HS is a valuable tool for improving surgical outcomes in breast cancer treatment.