Accuracy of Intraoperative Frozen-Section Analysis of Breast Cancer Lumpectomy-Bed Margins

Cendán, Juan; Coco, Dominique; Copeland, Edward M.

doi:10.1016/j.jamcollsurg.2005.03.014

Cited by 156 publications

(109 citation statements)

References 5 publications

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“…1 On both sides of the Atlantic, breast conserving surgery (BCS) is the most commonly performed surgical treatment for women with early stage breast cancer. 2,3 Unfortunately, on average, approximately 20% of patients undergoing BCS require a re-operation for close or positive resection margins.…”

Section: Main Manuscript Introductionmentioning

confidence: 99%

Diagnostic Accuracy of Intraoperative Techniques for Margin Assessment in Breast Cancer Surgery

et al. 2017

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Section: Main Manuscript Introductionmentioning

confidence: 99%

Diagnostic Accuracy of Intraoperative Techniques for Margin Assessment in Breast Cancer Surgery

et al. 2017

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“…Two common tools used for intra-operative margin assessment are touch-prep or imprint cytology and frozen section [13]. In experienced hands and with proper resources, these tools can reduce the re-excision rate to as low as 20% [6,14,15]. However, many institutions may not have pathologists readily available or the necessary resources to support these specialized techniques [16].…”

Section: Introductionmentioning

confidence: 99%

A low-cost, portable, and quantitative spectral imaging system for application to biological tissues

Fu¹,

Yu²,

Lo³

et al. 2010

Opt. Express

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Abstract:The ability of diffuse reflectance spectroscopy to extract quantitative biological composition of tissues has been used to discern tissue types in both pre-clinical and clinical cancer studies. Typically, diffuse reflectance spectroscopy systems are designed for single-point measurements. Clinically, an imaging system would provide valuable spatial information on tissue composition. While it is feasible to build a multiplexed fiber-optic probe based spectral imaging system, these systems suffer from drawbacks with respect to cost and size. To address these we developed a compact and low cost system using a broadband light source with an 8-slot filter wheel for illumination and silicon photodiodes for detection. The spectral imaging system was tested on a set of tissue mimicking liquid phantoms which yielded an optical property extraction accuracy of 6.40 ± 7.78% for the absorption coefficient (µ a ) and 11.37 ± 19.62% for the wavelength-averaged reduced scattering coefficient (µ s '). ©2010 Optical Society of America

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“…SMMG is convenient, easy and cost-effective, and has been used for margin assessment in our institution. Several studies have demonstrated that intraoperative margin assessment using frozen sections of the surgical specimen is useful (12,(18)(19)(20). However, histological intraoperative margin assessment may be associated with prolonged operative time and requires pathological expertise.…”

Section: Discussionmentioning

confidence: 99%

Impact of intraoperative specimen mammography on margins in breast-conserving surgery

Hisada

Sawaki

Ishiguro

et al. 2016

Molecular and Clinical Oncology

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Abstract.A positive resection margin is one of the most significant risk factors for local breast cancer recurrence following breast-conserving surgery (BCS). Intraoperative specimen mammography (SMMG) is routinely used to evaluate the surgical margin at our institution. The aim of the present study was to assess the adequacy of SMMG for margin assessment. The patient cohort included 174 women who underwent BCS in 2006. The sensitivity and specificity of SMMG were assessed by comparing the margins assessed by histological and radiological methods. It was also examined whether the rate of positive histological margins was decreased by re-excision following SMMG evaluation. A total of 23 false-negatives and 6 false-positives were determined by SMMG. The sensitivity and specificity of SMMG margin assessment for patients with primary breast cancer were 20.6 and 94.6%, respectively. The positive predictive value was 50% and the negative predictive value was 82.2%. A subgroup analysis revealed that the sensitivity and specificity of SMMG in cases with ductal carcinoma in situ (DCIS) were higher compared with those in invasive ductal carcinoma. Furthermore, the positive histological margin rate was not affected by re-excision. Although the general usefulness of intraoperative SMMG was not proven, this procedure may be useful in specific cases, particularly those with DCIS and those diagnosed by stereotactic biopsy. A prospective study with exact criteria and a standard procedure is required. IntroductionThe standard surgical treatments for breast cancer are breast-conserving surgery (BCS) and mastectomy. The essential purpose of BCS is to completely remove the cancer while maintaining the cosmetic appearance of the breast, which is important to the patients. Previous studies have reported that BCS followed by radiation had a similar outcome to that of mastectomy in terms of mortality rate (1-5). However, a positive margin and young age (<53-55) are significant risk factors for ipsilateral breast tumor recurrence (IBTR) (6-8). Moreover, a meta-analysis by the Early Breast Cancer Trialists' Collaborative Group showed that local recurrence affected survival rate (9). Recently, Moran et al (10) reported that the American Society of Radiation Oncology consensus guideline uses the results of a meta-analysis of margin width and IBTR. This guideline also indicated the optimal criteria for determining margin width in BCS. However, despite numerous previous studies, the criteria for intraoperative margin assessment in BCS have yet to be established. At our institution, intraoperative specimen digital mammography (SMMG) is used to assess the resection margins in all cases of BCS. The aim of the present study was to evaluate the usefulness of SMMG for achieving margin-free resection of breast tumors. Patients and methods Patients.A retrospective study of the medical records, pathological diagnosis and re-evaluation by SMMG of 426 breast cancer patients who underwent BCS at the Aichi Cancer Center Hospital (Nagoya, Japan) between J...

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Accuracy of Intraoperative Frozen-Section Analysis of Breast Cancer Lumpectomy-Bed Margins

Cited by 156 publications

References 5 publications

Diagnostic Accuracy of Intraoperative Techniques for Margin Assessment in Breast Cancer Surgery

Diagnostic Accuracy of Intraoperative Techniques for Margin Assessment in Breast Cancer Surgery

A low-cost, portable, and quantitative spectral imaging system for application to biological tissues

Impact of intraoperative specimen mammography on margins in breast-conserving surgery

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