High resolution intra-operative two-dimensional specimen mammography and its impact on second operation for re-excision of positive margins at final pathology after breast conservation surgery - 22/09/11
, Ann Harris, M.D. a, Mary Davey, M.D. b, Poonam Sharma, M.D. c, Edibaldo Silva, M.D., Ph.D. d
Corresponding author. Tel.: 402-280-4231; fax: 402-280-4278Abstract |
Background |
In the United States, about 50% to 66% of women undergoing breast conservation surgery for cancer undergo subsequent mastectomy for positive margins on initial lumpectomy. This is despite the fact that screening mammography has resulted in a decrease in the size of newly diagnosed breast cancer to <2 cm.
Methods |
A retrospective review of 128 patients who underwent breast conservation surgery for early breast cancer was performed using intraoperative 2-dimensional Faxitron high-resolution specimen mammography without specimen compression as the only margin assessment technique. Of these, 29 patients had histories of lumpectomy with positive margins.
Results |
A total of 131 procedures were performed. Margins were histologically clear at initial breast conservation surgery in 84.3% of patients who underwent primary lumpectomy. Subsequent reexcision for positive margins was required in 14.7% of patients. Two-dimensional Faxitron mammographically guided intraoperative reexcision cleared the margins in 95.8% of patients (23 of 24) who would have otherwise required subsequent reexcision.
Conclusions |
Intraoperative 2-dimensional Faxitron high-resolution specimen mammography can decrease rates of margin positivity and has the potential to diminish the number of subsequent undesired mastectomies for positive margins.
El texto completo de este artículo está disponible en PDF.Keywords : Intraoperative margin assessment, Specimen mammography, Reexcision rates, Failed breast conservation
Esquema
Vol 202 - N° 4
P. 387-394 - octobre 2011 Regresar al número
Artículo precedente
- Does prehospital prolonged extrication (entrapment) place trauma patients at higher risk for venous thromboembolism?
- Frederick B. Rogers, Sally J. Hammaker, Jo Ann Miller, John C. Lee, Roxanne Chandler, Mathew M. Edavettal, Lois U. Sakorafas, Daniel Wu, Tracy Evans, Lanyce A. Horn, Michael Horst
- Overcoming challenges in implementing a minimally invasive esophagectomy program at a Veterans Administration medical center
- George Rossidis, Nicole Kissane, Steve N. Hochwald, William Zingarelli, George Sarosi, Kfir Ben-David
Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
El acceso al texto completo de este artículo requiere una suscripción.
¿Ya suscrito a @@106933@@ revista ?