Ultrasound-guided breast-conserving surgery is superior to the palpation-guided surgery for palpable breast cancer

The purpose of this study is to verify whether the performance of ultrasound-guided quadrantectomy (USGQ) versus palpation-guided quadrantectomy (PGQ) can reduce the incidence of positive margins and if it can change the attitude of the surgeon. A retrospective study was conducted on 842 patients underwent quadrantectomy for breast cancer, 332 of them underwent USGQ, whereas 550 underwent PGQ. The histological type of the tumors and the margin status obtained with the histological examination were compared. The histological examination of the surgical specimen showed involvement of the margins in 24/842 patients (2.85%), 22 (2.61%) of them belonged to the PGQ group, and two to the USGQ group (P = 0.0011). The highest rate of microscopically positive margins was, statistically significant, for carcinoma in situ, when compared with patients with invasive carcinoma (0.0001). USGQ technique showed several advantages compared with PGQ. In fact, the former notes a lower positive margin rate and, consequently, a lower rate of reintervention. In addition, it may change the surgeon's attitude by causing him to remove another slice of margin to ensure more histological negativity. It should be the gold standard technique for breast-conservative surgery of palpable tumors.

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Abstract P5-15-03: Cost-effectiveness of ‘radioguided occult lesion localization’ (ROLL) versus ‘wire-guided localization’ (WGL) in breast conserving surgery for non-palpable breast cancer: results from a randomized controlled multicentre trial

10.1158/0008-5472.sabcs12-p5-15-03 ◽

2012 ◽

Author(s):

EL Postma ◽

E Koffijberg ◽

HM Verkooijen ◽

AJ Witkamp ◽

MA van den Bosch ◽

...

Keyword(s):

Breast Cancer ◽

Cost Effectiveness ◽

Multicentre Trial ◽

Breast Conserving Surgery ◽

Randomized Controlled ◽

Radioguided Occult Lesion Localization ◽

Occult Lesion ◽

Palpable Breast ◽

Lesion Localization

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Abstract PD04-01: Intra-operative ultrasound in breast-conserving surgery for palpable breast cancer significantly improves both surgical accuracy and cosmetic outcome while saving costs.

10.1158/0008-5472.sabcs12-pd04-01 ◽

2012 ◽

Cited By ~ 1

Author(s):

M Haloua ◽

N Krekel ◽

V Coupe ◽

P van den Tol ◽

S Meijer

Keyword(s):

Breast Cancer ◽

Breast Conserving Surgery ◽

Cosmetic Outcome ◽

Palpable Breast ◽

Operative Ultrasound

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3-D MRI guided breast conserving surgery

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.610 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 610-610

Author(s):

K. Hisamatsu

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Tumor Size ◽

Breast Conserving Surgery ◽

Resected Specimen ◽

Tumor Diameter ◽

Breast Cancer Patients ◽

3D Mri ◽

Guided Surgery ◽

Mri Guided

610 Background: In breast cancer patients, accurate diagnosis of ductal spreading is of great importanace for deciding sugical procedure. The role of imaging diagnosis using 3D-MRI in deciding of ductal spreading was assessed histologically and efficacy of 3D-MRI guided surgery was evaluated. Methods: Preoperative 3D-MRI was underwent 374 cases of breast cancer patients. Images were obtained 371 cases (99%). These patients could be divided into four groups according to 3D-MRI images: pattern 1) localized type, 2) widely enhanced type A (enhanced area: less than Quadrant) and 3) widely enhanced type B (enhanced area: more than Quadrant) and 4) multifocal type. Diagnosis of ductal spreading was confirmed histologically and relation between 3D-MRI patterns and ductal spreading were assessed retrospectively. Local failure of 3D-MRI guided surgery was assessed by 3D-MRI image patterns Results: The rate of histological confirmed ductal spreading were seen in 59% (125/212cases), 86% (49/57 cases) and 83% (19/23cases) of patients with 3D-MRI pattern 1), 2), and 3), respectively. From April 2005, resected specimen was serially step cut and total specimens were evaluated. Tumor diameter from nipple side to lateral margin were measured by MRI and resected specimens, tumor size was correlated between MRI and resected specimens, significantly (n=80, r=0.790887, P < 0.001). Whole breast examination revealed that only 4 cases were multifocal cancer in 17 cases of multifocal image in 3D-MRI. Patient selection for breast conserving surgery was based by 3D-MRI images. The proportion of breast-conserved surgery were obtained 96% (203/212 cases), 86% (49/57 cases), 26% (6/23cases) and 89% (68/76 cases) of patients with 3D-MRI pattern 1), 2), 3), and 4), respectively. Local failures were seen 2cases in pattern 1), one case in 3) and one case in 4) (2–77 months, median follow up 39 months). Conclusions: These results suggest that MRI will be the useful breast imaging tool in diagnosing ductal spreading and tumor size in breast cancer patients. Safety breast conserving surgery was achieved by MRI guided surgery. No significant financial relationships to disclose.

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