title: Intraoperative digital specimen mammography: rapid, accurate results expedite surgery.
abstract: BACKGROUND
  Specimen mammography during image guided breast surgery is a daily occurrence. The process of specimen travel, imaging and reporting may take 20-30 minutes. An intraoperative method to obtain digital specimen mammograms may expedite the process. We compared intraoperative digital specimen mammography (IDSM) as well as standard specimen mammography (SSM) on 121 consecutive image guided lumpectomies.
  
  
  METHODS
  Each lumpectomy specimen had IDSM obtained followed by travel to radiology for SSM. Surgical decisions were based on all imaging obtained. Data included 1) the ability of each imaging method to identify the target lesion, 2) degree of concordance of surgical interpretation of IDSM compared to radiologist interpretation of SSM, 3) the time required from lumpectomy to surgical review of images from each method, and 4) potential operative time savings.
  
  
  RESULTS
  Intraoperative digital specimen mammography (IDSM) was equally as accurate as standard x-ray film specimen mammography. There was no significant difference between 1) the frequency of identification of the target lesion by surgeon or radiologist, 2) lack of identification of any lesion, or 3) frequency of involved margins using imaging criteria. However, there was a marked difference in 1) the time needed to obtain images ready to read, 2) the ability to re-excise tissue promptly, and 3) the overall operating room time with an average decrease of 19 minutes.
  
  
  CONCLUSIONS
  Intraoperative digital specimen mammography (IDSM) was equally accurate as SSM obtained in this study. Use of this new technology allows surgeons to quickly view specimen images which translate into shorter more efficient operations.
authors.affiliation: Department of Surgery, University of Washington, Washington, USA. breastcare@aol.com
authors.forename: Cary S
authors.initials: CS
authors.lastname: Kaufman
authors.forename: Leslie
authors.initials: L
authors.lastname: Jacobson
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Bachman
authors.forename: Lauren B
authors.initials: LB
authors.lastname: Kaufman
authors.forename: Carol
authors.initials: C
authors.lastname: Mahon
authors.forename: Laura-Jane
authors.initials: LJ
authors.lastname: Gambrell
authors.forename: Roger
authors.initials: R
authors.lastname: Seymour
authors.forename: Jennifer
authors.initials: J
authors.lastname: Briscoe
authors.forename: Karen
authors.initials: K
authors.lastname: Aulisio
authors.forename: Angi
authors.initials: A
authors.lastname: Cunningham
authors.forename: Francis
authors.initials: F
authors.lastname: Opstad
authors.forename: Nancy
authors.initials: N
authors.lastname: Schnell
authors.forename: Jan
authors.initials: J
authors.lastname: Robertson
authors.forename: Lynne
authors.initials: L
authors.lastname: Oliver
mesh_terms: D001941:Breast Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D003199:Computer Systems; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008327:Mammography / Q000379:methods*; D015412:Mastectomy, Segmental; D011856:Radiographic Image Enhancement; D015203:Reproducibility of Results; D013997:Time Factors