Preoperative and intraoperative predictors of positive margins after breast-conserving surgery: a retrospective review

Saadai, Payam; Moezzi, Manijeh; Menes, Tehillah S.

doi:10.1007/s12282-011-0262-9

Cited by 16 publications

(10 citation statements)

References 21 publications

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“…17,18 Tumour factors that have been shown to increase re-excision rates include patient age, presence of ductal carcinoma in situ (DCIS), large size of invasive or in situ component, high grade, lobular phenotype and multifocality. 10,12,[19][20][21] Surprisingly, a recently published study of all National Health Service centres in England found the re-operation rate was not associated with volume of activity. 22 In 2009, BreastScreen WA performed 91 319 screening mammograms and identified 579 cancers.…”

Section: Introductionmentioning

confidence: 98%

Predictors of re‐excision in wire‐guided wide local excision for early breast cancer: a Western Australian multi‐centre experience

Ballal

Taylor

Bourke

et al. 2015

ANZ Journal of Surgery

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Section: Introductionmentioning

confidence: 98%

Predictors of re‐excision in wire‐guided wide local excision for early breast cancer: a Western Australian multi‐centre experience

Ballal

Taylor

Bourke

et al. 2015

ANZ Journal of Surgery

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“…Localized breast tumors are typically managed by breast-conserving surgery (BCS) combined with adjuvant radiotherapy, which provides comparable survival outcomes to traditional mastectomy [1,2], whilst providing a better cosmetic result. However, if histopathology of the resected specimen reveals tumor extending to the surgical margin, the so-called positive margin, then further resection is advised until a clear margin is obtained, since margin positivity is an important risk factor for recurrent disease [1]. Re-operation for positive tumor margin status can result in a poor cosmetic outcome, increased patient anxiety, delayed adjuvant therapy and increased treatment costs [1,2].…”

Section: Introductionmentioning

confidence: 99%

“…However, if histopathology of the resected specimen reveals tumor extending to the surgical margin, the so-called positive margin, then further resection is advised until a clear margin is obtained, since margin positivity is an important risk factor for recurrent disease [1]. Re-operation for positive tumor margin status can result in a poor cosmetic outcome, increased patient anxiety, delayed adjuvant therapy and increased treatment costs [1,2]. The frequency of positive margins following BCS varies depending on the health care setting.…”

Section: Introductionmentioning

confidence: 99%

Registration of Supine MR Mammography with Breast Ultrasound for Surgical Planning of Breast Conserving Surgery: A Feasibility Study

Pickles

Gibbs

Hubbard

et al. 2018

Senologie - Zeitschrift für Mammadiagnostik und -therapie

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Purpose To report the feasibility, accuracy and initial clinical experience of the use of real-time magnetic resonance navigated ultrasound (rtMRnUS) in the surgical planning of breast-conserving surgery (BCS) via guide wire insertion. Materials and Methods 29 participants were recruited into this prospective ethics committee approved study. The first 4 cases were utilized as a training set. Participants underwent a supine contrast-enhanced breast MR examination with external fiducials and corresponding ink marks placed on the skin of the affected breast to act as co-registration pairs. MR examinations included both functional and morphological images. A LOGIQ E9 ultrasound system (GE Healthcare, Milwaukee, WI, USA) equipped with a 6 – 15 MHz transducer was utilized for rtMRnUS. To facilitate point co-registration of the previously acquired MR dataset with the real-time ultrasound, co-registration pairs were identified on both imaging modalities. The following co-registration quality metrics were recorded: root mean square deviation (RMSD), lesion and global accuracies. Post co-registration guide wire insertion was performed. Results Co-registration was successfully undertaken in all participants. Results from 25 participants are presented. The median (min, max) RMSD was 3.3 mm (0.6 mm, 8.8 mm). The global accuracy was assessed as very good (8), good (12), moderate (3) and poor (2) while the median (min, max) lesion accuracy was recorded at 8.9 mm (2.1 mm, 33.2 mm). Conclusion The use of rtMRnUS to facilitate guide wire insertion is a feasible technique. Generally, very good or good global registration can be expected. Lesion accuracy results indicate that a median difference, in 3 D space, of 9 mm can be expected between imaging modalities.

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“…Localised breast tumours are typically managed by breast conserving surgery (BCS) combined with adjuvant radiotherapy, which provides comparable survival outcomes to traditional mastectomy [1,2], whilst providing a better cosmetic result. However, if histopathology of the resected specimen reveals tumour extending to the surgical margin, so called positive margin, then further resection is advised until a clear margin is obtained, since margin positivity is an important risk factor for recurrent disease [1]. Re-operation for positive tumour margin status can result in poor cosmetic outcome, increased patient anxiety, delayed adjuvant therapy and increased treatment costs [1,2].…”

Section: Introductionmentioning

confidence: 99%

Registration of Supine MR Mammography with Breast Ultrasound for Surgical Planning of Breast Conserving Surgery: A Feasibility Study

et al. 2015

View full text Add to dashboard Cite

To report the feasibility, accuracy and initial clinical experience of the use of real-time magnetic resonance navigated ultrasound (rtMRnUS) in the surgical planning of breast-conserving surgery (BCS) via guide wire insertion. 29 participants were recruited into this prospective ethics committee approved study. The first 4 cases were utilized as a training set. Participants underwent a supine contrast-enhanced breast MR examination with external fiducials and corresponding ink marks placed on the skin of the affected breast to act as co-registration pairs. MR examinations included both functional and morphological images. A LOGIQ E9 ultrasound system (GE Healthcare, Milwaukee, WI, USA) equipped with a 6 - 15 MHz transducer was utilized for rtMRnUS. To facilitate point co-registration of the previously acquired MR dataset with the real-time ultrasound, co-registration pairs were identified on both imaging modalities. The following co-registration quality metrics were recorded: root mean square deviation (RMSD), lesion and global accuracies. Post co-registration guide wire insertion was performed. Co-registration was successfully undertaken in all participants. Results from 25 participants are presented. The median (min, max) RMSD was 3.3 mm (0.6 mm, 8.8 mm). The global accuracy was assessed as very good (8), good (12), moderate (3) and poor (2) while the median (min, max) lesion accuracy was recorded at 8.9 mm (2.1 mm, 33.2 mm). The use of rtMRnUS to facilitate guide wire insertion is a feasible technique. Generally, very good or good global registration can be expected. Lesion accuracy results indicate that a median difference, in 3 D space, of 9 mm can be expected between imaging modalities.

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Preoperative and intraoperative predictors of positive margins after breast-conserving surgery: a retrospective review

Abstract: In the era of preoperative diagnosis of breast cancer with core biopsy, several pre- and intraoperative predictors of positive margins are identified that can aid the surgeon in surgical planning.

Cited by 16 publications

References 21 publications

Predictors of re‐excision in wire‐guided wide local excision for early breast cancer: a Western Australian multi‐centre experience

Predictors of re‐excision in wire‐guided wide local excision for early breast cancer: a Western Australian multi‐centre experience

Registration of Supine MR Mammography with Breast Ultrasound for Surgical Planning of Breast Conserving Surgery: A Feasibility Study

Registration of Supine MR Mammography with Breast Ultrasound for Surgical Planning of Breast Conserving Surgery: A Feasibility Study

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