Usefulness of lesion image mapping with multidetector-row helical computed tomography using a dedicated skin marker in breast-conserving surgery.
To investigate the usefulness of computed tomography (CT) with skin-marker placement in determining the excision area and decreasing the positive or close margin rates in breast-conserving surgery (BCS). Multidetector-row helical computed tomography (MDCT) mapping images were reconstructed in subjects (n = 117) diagnosed with primary breast cancer who had undergone MDCT using CT skin markers. Serial 5-mm-thick slices prepared from the surgical specimen were used for pathological analyses. A "positive margin" was defined as the presence of malignant cells at the surgical margin, and a "close margin" as a tumor within 5 mm of the surgical margin. The rates of positive and close margins were calculated. We identified the lesions in 111 of 117 cases (94.9%) on MDCT. Of these, 93 underwent BCS under the guidance of MDCT mapping and the remaining 18 underwent mastectomy. Among the 93 cases, 6 (6.5%) had positive or close margins and were diagnosed with ductal carcinoma in situ of low nuclear grade. MDCT mapping with a CT skin marker is feasible for simulating surgical positioning and determining the excision area. MDCT mapping could decrease the positive and close margin rates in BCS.
Harada-Shoji
Narumi
N
Department of Surgical Oncology, Sendai, Japan. vecchio03@ybb.ne.jp
Yamada
Takayuki
T
Ishida
Takanori
T
Amari
Masakazu
M
Suzuki
Akihiko
A
Moriya
Takuya
T
Ohuchi
Noriaki
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012867:Skin / Q000473:pathology*; D036542:Tomography, Spiral Computed / Q000295:instrumentation* / Q000379:methods*