Frozen Section Analysis for Intraoperative Margin Assessment During Breast-Conserving Surgery Results in Low Rates of Re-excision and Local Recurrence

Olson, Tyler; Harter, Josephine; Munoz, Alejandro; Mahvi, David M.; Breslin, Tara M.

doi:10.1245/s10434-007-9437-1

Cited by 184 publications

(117 citation statements)

References 23 publications

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“…6 and 7, 30 Â 30 mm en face images could be generated in approximately 3 minutes. This timeframe compares favorably with existing intraoperative techniques, such as frozen section, which typically takes approximately 25 minutes (44). In addition, recent advances in OCT technology have enabled data acquisition speeds of >1,000,000 A-scans per second, permitting volume acquisitions in <1 second (45), suggesting that entire lumpectomy samples could feasibly be scanned in <1 minute.…”

Section: Discussionmentioning

confidence: 79%

Investigation of Optical Coherence Microelastography as a Method to Visualize Cancers in Human Breast Tissue

et al. 2015

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An accurate intraoperative identification of malignant tissue is a challenge in the surgical management of breast cancer. Imaging techniques that help address this challenge could contribute to more complete and accurate tumor excision, and thereby help reduce the current high reexcision rates without resorting to the removal of excess healthy tissue. Optical coherence microelastography (OCME) is a three-dimensional, high-resolution imaging technique that is sensitive to microscale variations of the mechanical properties of tissue. As the tumor modifies the mechanical properties of breast tissue, OCME has the potential to identify, on the microscale, involved regions of fresh, unstained tissue. OCME is based on the use of optical coherence tomography (OCT) to measure tissue deformation in response to applied mechanical compression. In this feasibility study on 58 ex vivo samples from patients undergoing mastectomy or wide local excision, we demonstrate the performance of OCME as a means to visualize tissue microarchitecture in benign and malignant human breast tissues. Through a comparison with corresponding histology and OCT images, OCME is shown to enable ready visualization of features such as ducts, lobules, microcysts, blood vessels, and arterioles and to identify invasive tumor through distinctive patterns in OCME images, often with enhanced contrast compared with OCT. These results lay the foundation for future intraoperative studies. Cancer Res; 75(16); 3236–45. ©2015 AACR.

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Section: Discussionmentioning

confidence: 79%

Investigation of Optical Coherence Microelastography as a Method to Visualize Cancers in Human Breast Tissue

et al. 2015

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“…Highest rates of ipsilateral breast tumour recurrence (IBTR) were observed with margins less than 2 mm compared to larger negative margins. However, further decrease in local recurrence was not observed when margins of 2 mm or more were compared with margins of 5 mm or greater (5,6).…”

Section: Discussionmentioning

confidence: 81%

Local recurrence rate in patients with DCIS

Bartova

Suska²,

Pohlodek³

2012

BLL

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Abstract:Objectives: The aim of this observational retrospective study was to evaluate the local recurrence rate of ductal carcinoma in situ of the breast (DCIS) and/or invasive breast cancer in patients with DCIS or microinvasive carcinoma of the breast after breast conserving or radical surgery. Secondary aim of the study was comprehensive assessment of the whole management of DCIS and its comparison with European guidelines. Methods: The study was performed in a group of 41 women with DCIS or microinvasive cancer, who underwent surgical treatment (breast conserving or radical modifi ed mastectomy) at the IInd Department of Gynaecology and Obstetrics, University Hospital Bratislava (UNB), during the period 2001-2009. Documentation and pathological examination data from paraffi n embedded tissue sections were used as data source. We sent out questionnaires regarding data about additional postoperative treatment and course of the disease up to year 2010 with focus on recurrence or tumour de novo incidence. Results: Breast conserving surgery was performed in 28 cases -68 %, modifi ed radical mastectomy in 13 cases. All cases of mastectomy were due to multicentricity and/or extensive tumour >4 cm. Additional surgery due to unsatisfactory marginal status was performed in 8 patients (3.28 %). Additional treatment such as radiotherapy and/or hormonal therapy received 19 patients. Van Nuyss Prognostic Index was reported in 17 patients on the basis of histopathological data. 27 patients completed and returned questionnaire. No DCIS recurrence nor infi ltrating cancer or tumour de novo was reported in this group. Conclusion: We consider surgical management as adequate. Further material analysis is needed (Tab. 5, Fig. 1

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“…Such tools would enable the surgeon to more effectively remove all tumor during the initial surgery, hence reducing re-excision rates. A range of intraoperative techniques are currently used, including: frozen section analysis [8], imprint cytology [9], intraoperative specimen radiography [10] and intraoperative ultrasound [11]. However, these techniques are time consuming and reported positive margin rates using these techniques are greater than 20% [12].…”

Section: Introductionmentioning

confidence: 99%

Wide-field optical coherence micro-elastography for intraoperative assessment of human breast cancer margins

Allen

Chin

Wijesinghe

et al. 2016

Biomed. Opt. Express

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Incomplete excision of malignant tissue is a major issue in breast-conserving surgery, with typically 20 -30% of cases requiring a second surgical procedure arising from postoperative detection of an involved margin. We report advances in the development of a new intraoperative tool, optical coherence micro-elastography, for the assessment of tumor margins on the micro-scale. We demonstrate an important step by conducting whole specimen imaging in intraoperative time frames with a wide-field scanning system acquiring mosaicked elastograms with overall dimensions of ~50 × 50 mm, large enough to image an entire face of most lumpectomy specimens. This capability is enabled by a wide-aperture annular actuator with an internal diameter of 65 mm. We demonstrate feasibility by presenting elastograms recorded from freshly excised human breast tissue, including from a mastectomy, lumpectomies and a cavity shaving. Vitkin, "Hybrid method of strain estimation in optical coherence elastography using combined sub-wavelength phase measurements and supra-pixel displacement tracking," J. Biophotonics 9(5), 499-509 (2016

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Frozen Section Analysis for Intraoperative Margin Assessment During Breast-Conserving Surgery Results in Low Rates of Re-excision and Local Recurrence

Abstract: Intraoperative FSA allows resection of suspicious or positive margins at the time of lumpectomy and results in low rates of local recurrence and re-excision. The low local recurrence rate reported here is comparable to those reported with other margin assessment techniques.

Cited by 184 publications

References 23 publications

Investigation of Optical Coherence Microelastography as a Method to Visualize Cancers in Human Breast Tissue

Investigation of Optical Coherence Microelastography as a Method to Visualize Cancers in Human Breast Tissue

Local recurrence rate in patients with DCIS

Wide-field optical coherence micro-elastography for intraoperative assessment of human breast cancer margins

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