Intraoperative radiological margin assessment in breast-conserving surgery.
A prospective study was lead in order to analyze the accuracy of an X-ray device settled in the operating room for margin assessment, when performing breast-conserving surgery.


METHODS
One hundred and seventy patients were included. All lesions were visible on the preoperative mammograms. An intraoperative X-ray of the lumpectomy specimen was systematically performed for margins assessment. Final histological data were collected and the accuracy of intraoperative specimen radiography (IOSR) for margin assessment was analyzed.


RESULTS
IOSR allowed an evaluation of margins status in 155 cases (91.2%). After final histological examination, the positive margins rate would have been 6.5% if margin assessment had relied only on IOSR.


CONCLUSIONS
Margin assessment with a two-dimensional X-ray device would have allowed the achievement of negative margins in 93.5% of the cases. Moreover, this procedure allows important time-saving and could have a substantial economical impact.
Centre Antoine Lacassagne, Breast Cancer and Reconstructive Surgery Unit, France. Electronic address: t_ihrai@yahoo.fr.
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Ihrai
Centre Antoine Lacassagne, Breast Cancer and Reconstructive Surgery Unit, France.
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D
Quaranta
Centre Antoine Lacassagne, Breast Cancer and Reconstructive Surgery Unit, France.
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Y
Fouche
Centre Antoine Lacassagne, Breast Cancer and Reconstructive Surgery Unit, France.
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JC
Machiavello
Centre Antoine Lacassagne, Breast Cancer and Reconstructive Surgery Unit, France.
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Raoust
Centre Antoine Lacassagne, Radiology Unit, France.
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Chapellier
Centre Antoine Lacassagne, Radiology Unit, France.
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Maestro
Centre Antoine Lacassagne, Pathology Unit, France.
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Marcy
Centre Antoine Lacassagne, Breast Cancer and Reconstructive Surgery Unit, France.
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JM
Ferrero
Centre Antoine Lacassagne, Breast Cancer and Reconstructive Surgery Unit, France.
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Flipo
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D015412:Mastectomy, Segmental; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011859:Radiography
Breast cancer; Faxitron; Intraoperative histological examination; Intraoperative specimen radiography; Mammograms; Margins status