Intraoperative digital specimen mammography: rapid, accurate results expedite surgery.
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.
Kaufman
Cary S
CS
Department of Surgery, University of Washington, Washington, USA. breastcare@aol.com
Jacobson
Leslie
L
Bachman
Barbara A
BA
Kaufman
Lauren B
LB
Mahon
Carol
C
Gambrell
Laura-Jane
LJ
Seymour
Roger
R
Briscoe
Jennifer
J
Aulisio
Karen
K
Cunningham
Angi
A
Opstad
Francis
F
Schnell
Nancy
N
Robertson
Jan
J
Oliver
Lynne
L
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