title: [Specimen radiography assessment of surgical margins status in subclinical breast carcinoma: a diagnostic study].
abstract: OBJECTIVE
  This study aimed to determine the accuracy of specimen radiography in evaluating the surgical margins of impalpable breast carcinoma.
  
  
  METHODS
  Retrospective study from June 2009 to June 2010 in Orleans Hospital Center.
  
  
  METHODS
  The study involved patients with impalpable in situ breast carcinoma diagnosed by mammography. Only patients with larger in situ carcinoma than invasive carcinoma were included. Patients underwent a breast conserving surgery after preoperative localization of the lesion.
  
  
  METHODS
  Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the specimen radiography are determined by correlation between radiologic and histologic margins.
  
  
  CONCLUSIONS
  The following results were obtained from 46 patients: 36 DCIS cases (78%), six DCIS with IDC cases (13%), two LCIS cases (4%) and two biopsy suggested DCIS (4%). A radiologic margin of 2mm (by analogy with the histological margins) results in a NPV of 73%. NPV, sensibility and specificity were respectively 79, 60 and 74% for a radiologic margin of 5mm. The measure or inter-rater reliability found a moderate agreement (kappa: 0.62). The systematic review on this topic found only eight articles (small samples and only two prospective studies). We could not make any recommendations from the literature review on a threshold to define excision margin status.
  
  
  CONCLUSIONS
  The specimen radiography is a useful tool to assess margins of impalpable breast carcinoma. However, further studies are necessary as this point to determine a threshold for those radiologic margins.
authors.affiliation: Service de gynécologie-obstétrique, médecine fœtale et reproduction humaine, CHU Bretonneau, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex, France. chloe.fouche@hotmail.fr
authors.forename: C-J
authors.initials: CJ
authors.lastname: Fouché
authors.forename: F
authors.initials: F
authors.lastname: Tabareau
authors.forename: P
authors.initials: P
authors.lastname: Michenet
authors.forename: P
authors.initials: P
authors.lastname: Lebas
authors.forename: E-G
authors.initials: EG
authors.lastname: Simon
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D011859:Radiography; D015203:Reproducibility of Results; D012189:Retrospective Studies