A novel ultrasound-guided electrosurgical loop device for intra-operative excision of breast lesions; an improvement in surgical technique.
BACKGROUND
The rate of involved margins after the excision of breast lesions using standard surgical techniques has historically ranged from approximately 20% to 45%. The localization and excision of breast lesions using intraoperative ultrasound has provided significant improvement. The authors report their collective experience with a novel technique utilizing the Phantom flexible loop electrosurgical device under ultrasound guidance for the intraoperative excision of breast lesions.


METHODS
Seventy-nine breast lesions were excised using the Phantom device with intraoperative ultrasound. Rate of reexcision, excised specimen size, and size of the lumpectomy incision were reviewed.


RESULTS
Fifty-nine of 79 lesions were malignant. Fifty-one (86.4%) had noninvolved final margins; 8 (13.6%) involved margins. The average specimen size was 21.3 cm3, compared with a range of 60 to 100 cm3 in the literature.


CONCLUSIONS
These results demonstrate improved efficiency, a decrease in the volume of excision, smaller incision size, and very low need for reoperation secondary to involved margins using the Phantom device for real-time, ultrasound-guided lumpectomy.
Fine
Richard E
RE
Advanced Breast Care, Marietta, GA, USA. rfinemd@aol.com
Schwalke
Michael A
MA
Pellicane
James V
JV
Attai
Deanna J
DJ
D001940:Breast / Q000601:surgery*; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D004598:Electrosurgery / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental / Q000295:instrumentation; D011446:Prospective Studies; D018084:Ultrasonography, Interventional; D014481:United States