Breast specimen ultrasound and mammography in the prediction of tumour-free margins.
BACKGROUND
Adequacy of margins is important for local recurrence control in breast-conserving surgery for breast cancer. This study aims to compare the accuracy of intraoperative specimen ultrasonography (IOUS) and specimen mammography in the prediction of achieving adequate histologically tumour-free margins during breast-conserving surgery.


METHODS
Between March 2003 and September 2004, a prospective study was carried out on 25 patients who underwent breast-conserving surgery. After wide excision, IOUS and specimen mammography were used to assess adequacy of margins. Further surgery was undertaken when either method showed an inadequate margin. The margins were assessed histologically and correlated with IOUS and mammographic findings.


RESULTS
Using IOUS alone, higher rates of histologically tumour-free margins were achieved compared with mammography alone. Combined IOUS and mammography achieved similar or slightly higher rates of histologically tumour-free margins compared with IOUS alone. If the margin measured on IOUS is twice the desired histological margin, this will result in achieving a histologically tumour-free rate of >90%. Associated ductal carcinoma in situ was the only significant factor found to decrease the rate of achieving adequate margins.


CONCLUSIONS
Intraoperative specimen ultrasonography is useful in predicting histologically tumour-free margins during breast conserving surgery for cancer.
Tan
Kok-Yang
KY
Department of General Surgery, Breast Service, Changi General Hospital, Singapore. kok_yang_tan@cgh.com.sg
Tan
Su-Ming
SM
Chiang
Siew-Hwa
SH
Tan
Andrew
A
Chong
Chee-Keong
CK
Tay
Khoon-Hean
KH
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008327:Mammography; D015412:Mastectomy, Segmental; D008875:Middle Aged; D011446:Prospective Studies; D016217:Ultrasonography, Mammary