The role of tomosynthesis in intraoperative specimen evaluation

Abstract

To investigate the contribution of breast tomosynthesis to intraoperative specimen evaluation in subjects with breast cancer. Approval was obtained from the hospital ethics committee. Specimen mammography, tomosynthesis, and, if available, ultrasonography images were retrospectively assessed for 208 women who had undergone conservative surgery at our hospital between January 2013 and April 2016 after being diagnosed with breast cancer. The success of mammography, tomosynthesis, and ultrasonography in lesion detection and characterization was evaluated. Of 208 lesions, 142 (68.3%) and 198 (95.2%) were detected by mammography and tomosynthesis, respectively. All lesions were detected in 150 subjects undergoing ultrasonography (124 dense breasts, 26 fatty breasts). In 84 women who had fatty breasts, all lesions were detected both by mammography and by tomosynthesis. In 124 women with dense breasts, lesions were detected by mammography in 59 (48%) and in 114 (92%) by tomosynthesis. The success of tomosynthesis in lesion detection was found to be markedly higher than mammography (P = .00). In conclusion, tomosynthesis contributed to mammography in specimen evaluation in a total of 101 subjects. The success of tomosynthesis in lesion detection and characterization during intraoperative specimen evaluation is higher than mammography. In daily practice, ultrasonography is performed for lesions which cannot be evaluated by specimen mammography due to dense parenchymal pattern. Tomosynthesis may reduce the need for and the time and workforce allocated to specimen ultrasonography in an important group of subjects.

Computer Vision Analysis of Specimen Mammography to Predict Margin Status

“…35,36 Newer imaging techniques, such as 3D tomosynthesis or optical coherence tomography may also be more accurate compared with specimen mammography and result in improved models. [37][38][39] However, the current approach has the advantage of using widely available systems rather than new hardware, which may be costly. Finally, we did not assess radiologist or surgeon accuracy for margin classification on our dataset, although this is likely to be similar to previous literature.…”

Comparação entre a tomossíntese e a ressonância magnética da mama para avaliar resposta tumoral após quimioterapia neoadjuvante: relato de caso

“…A quimioterapia neoadjuvante é a quimioterapia realizada antes da cirurgia com o objetivo de reduzir o tamanho do tumor tornando-o operável e possibilitando a cirurgia mais conservadora. O objetivo da colocação do clipe no leito tumoral é mostrar ao examinador a localização e tamanho do tumor na resposta completa ou parcial após a quimioterapia neoadjuvante (POLAT et. al., 2018).…”

Breast lesion size assessment in mastectomy specimens

“…DBT during intraoperative specimen evaluation was for lesion detection and characterization higher than for FFDM. [28] DBT may reduce the need allocated specimen ultrasonography in patients with dense breast tissue.…”