title: Intra-operative assessment of excision margins using breast imprint and scrape cytology.
abstract: Local recurrence in breast cancer surgery is related to the completeness of excision. Histological analysis of excision margins is time consuming and impractical for use intra-operatively. Our group evaluated breast imprint and scrape cytology (ISC) for the assessment of excision margins in a feasibility study in 1993-4, with 10 year clinical follow-up. Twenty-six consecutive women undergoing 27 wide local excisions for breast cancer had excision margins prospectively assessed with intra-operative ISC blinded to histology. All ISC results were ready (range 22-30 min) before surgery was completed. ISC agreed with histology in 21/27 (=78%) and disagreed in 6/27 (=22%) of the cases. In two cases with local recurrence, histology was positive in one case, whereas ISC margins were positive in both. Intra-operative ISC is reliable and could help the surgeon to excise more tissue to prevent a second (re-excision) operation. ISC margins may predict clinical outcome, although a larger interventional follow-up study is required.
authors.affiliation: Department of Breast Surgery, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK. masoom@orange.net
authors.forename: M
authors.initials: M
authors.lastname: Muttalib
authors.forename: C C
authors.initials: CC
authors.lastname: Tai
authors.forename: T
authors.initials: T
authors.lastname: Briant-Evans
authors.forename: I
authors.initials: I
authors.lastname: Maheswaran
authors.forename: N
authors.initials: N
authors.lastname: Livni
authors.forename: S
authors.initials: S
authors.lastname: Shousha
authors.forename: H D
authors.initials: HD
authors.lastname: Sinnett
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D003584:Cytological Techniques; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D015588:Observer Variation; D011446:Prospective Studies