title: An evaluation of intraoperative digital specimen mammography versus conventional specimen radiography for the excision of nonpalpable breast lesions.
abstract: BACKGROUND
  This study examined the impact of intraoperative digital specimen mammography (IDSM) compared with conventional specimen radiography (CSR) for nonpalpable breast lesions in patients undergoing breast-conserving surgery (BCS).
  
  
  METHODS
  In this retrospective cohort study, 201 consecutive image-detected nonpalpable breast lesions underwent BCS after preoperative localization and specimen radiography. Data on patient, tumor, and surgical factors were collected.
  
  
  RESULTS
  CSR was performed in 105 patients and IDSM was used in 96 patients. Patient and tumor factors were similar in both groups. Using univariate analysis, CSR resulted in more positive margins (19% vs 6.2%; P = .012). Rates of cavity margin resection, reoperation, and operative times were similar for CSR and IDSM. Independent predictors of positive margins on multivariable analysis were use of CSR, microcalcifications on mammography, the need for bracketing for localization, and no cavity margin excision (all P < .05).
  
  
  CONCLUSIONS
  In this study, the use of IDSM resulted in fewer positive margins after BCS, although operative times were similar.
authors: Department of Surgery, McMaster University and St. Joseph's Healthcare, Hamilton, Ontario, Canada.
authors: Song Hon H
authors: SH
authors: Kim
authors: Sylvie D
authors: SD
authors: Cornacchi
authors: Barbara
authors: B
authors: Heller
authors: Forough
authors: F
authors: Farrokhyar
authors: Melissa
authors: M
authors: Babra
authors: Peter J
authors: PJ
authors: Lovrics
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D002114:Calcinosis; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000601:surgery; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008327:Mammography / Q000379:methods*; D015412:Mastectomy, Segmental; D008875:Middle Aged; D015999:Multivariate Analysis; D061646:Operative Time; D011856:Radiographic Image Enhancement; D012086:Reoperation; D012189:Retrospective Studies