In breast- conserving surgery (BCS) for breast cancer treatment, it is well established that adequate margins are important for control of local recurrence. However, it is difficult to determine adequate margin of non-palpable breast lesions. We examined the value of intra-operative specimen mammography in determining margin status of excised breast lesions, and the concordance between the radiologic and the final pathologic interpretation of margin status. We evaluated whether preoperative mammographic density influence to analyze specimen mammography.
We prospectively enrolled 182 patients who had breast cancer treated by breast conserving surgery between October 2011 and September 2013, and 158 patients were investigated the clinical and pathological data. After wide excision, intra-operative specimen mammography were used to access adequacy of margins. Further resection was done when resection margin showed close to lesions. The margin were assessed histologically and correlated with specimen mammographic findings.We assessed the efficacy of specimen mammography according to breast density and also, compare to intra-operative frozen section and inspection/palpation group from our database.
|Frozen section analysis||Specimen mammography||Inspection/ palpation||p-value|
|Operation time (min)||108.4 (45-215)||85.2 (20-175)||65.4 (15-110)||0.026|
|Very-close margin*/total (%)||12/64 (18.8)||39/158 (24.7)||34/114 (30.0)||0.421|
|Positive marginâ / total (%)||7/64 (10.9)||19/158 (12.0)||22/114 (19.3)||0.196|
|2nd operation/total (%)||8/64 (12.5)||16/158 (10.1)||21/114 (18.4)||0.252|
In conclusion, we suggest that specimen mammography can useful for assessment of margin status especially in lesions that non-palpable or with microcalcifications. Also, preoperative mammographic density can be considered that may affect the possibility of margin assessment on specimen mammography.
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All authors have declared no conflicts of interest.