Utilization of Tumor Markers for Intraoperative Specimen Radiography Does Not Decrease the Rate of Margin Positivity...

Area of Science:

• Oncology
• Surgical Oncology
• Radiology

Background:

• Accurate margin assessment after lumpectomy is critical for preventing local recurrence in invasive breast carcinoma.
• Current "no ink on tumor" guidelines may lead to positive margins and re-excision in up to 20% of patients.
• The study investigates a novel tumor marking system to improve margin assessment during breast conservation surgery.

Purpose of the Study:

• To evaluate the impact of a commercial tumor marking system on re-excision rates in breast conservation surgery.
• To assess if the tumor marking system improves margin status assessment for invasive breast carcinoma.

Main Methods:

• A prospective cohort (n=105) using a tumor marking system and radiography was compared to a retrospective control group (n=92).
• Lumpectomy specimens in the study group were marked with clips, followed by radiography to guide potential additional margin excisions.
• Statistical analysis compared margin excision rates and final margin positivity between the study and control groups.

Main Results:

• The study group showed significantly different rates of margin excision compared to the control group (P ≤ 0.0105).
• While positive margins were similar (24% study vs. 21% control, P ≤ 0.0810), the study group had fewer selective or complete margin excisions.
• The tumor marking system led to a significant decrease in patients requiring additional margin excision procedures.

Conclusions:

• The investigated tumor marking system did not reduce the overall rate of positive margins in invasive breast carcinoma.
• However, the system significantly decreased the number of patients needing further margin excisions, potentially streamlining surgical workflows.
• Further research may explore optimizing the use of such marking systems to enhance margin-negative outcomes in breast conservation surgery.