Intraoperative ultrasound localization to guide surgical excision of nonpalpable breast carcinoma.
BACKGROUND
This report describes a technique of intraoperative tumor localization by ultrasound without the use of a needle or wire to guide the excision of nonpalpable breast cancers. The results of our experience with pathologic margin status are reviewed.


METHODS
From 1994 to 1998, 65 breast cancers in 62 patients with biopsy-proved nonpalpable breast cancer were excised using intraoperative ultrasound localization. The pathologic status of the margins from the initial surgical excision specimen and any further excisions, either at the first operation or later procedures, was recorded. The distance from the tumor to the closest margin of excision was also determined.


RESULTS
The overall success in achieving pathologically negative excision margins at first operation was 97% (63 of 65 cancers). Three patients underwent a second operative procedure, two for positive margins and one for a margin less than 1 mm (second operation = 4.8% of patients). After completion of the first operative procedure, the mean distance to the closest margin of excision was 0.8 cm.


CONCLUSIONS
Intraoperative ultrasound localization for excision of nonpalpable breast cancers is feasible and gives results, in terms of pathologic margins, that are comparable with those achieved by standard needle-wire-guided excisions.
Harlow
S P
SP
Department of Surgery, Fletcher-Allen Health Care, the University of Vermont, College of Medicine, and the Vermont Cancer Center, Burlington 05405-0068, USA.
Krag
D N
DN
Ames
S E
SE
Weaver
D L
DL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008875:Middle Aged; D012086:Reoperation; D016896:Treatment Outcome; D016217:Ultrasonography, Mammary / Q000379:methods