title: The CUBE technique: continuous ultrasound-guided breast excision.
abstract: BACKGROUND
  Margin negativity is a critical endpoint in breast-conserving surgery. Despite advances in technology, there is up to a 40 % positive margin rate in lumpectomy specimens, which results in a twofold increase in ipsilateral breast tumor recurrence. We have developed a new method for lumpectomy that could improve margin negativity.
  
  
  METHODS
  A novel method for partial mastectomy was developed using ultrasound to perform dissection of breast specimens in real time. Continuous ultrasound-guided breast excision (CUBE) was first tested on gel models and subsequently implemented in vivo. The step-by-step method for this technique was performed on 12 successive patients who had ultrasound-detectable lesions.
  
  
  RESULTS
  Twelve patients underwent lumpectomy for cancer using the CUBE technique. All patients had negative margins on final pathology. Three patients who had close margins on ex vivo ultrasound evaluation had additional shave margins taken, resulting in negative final margins.
  
  
  CONCLUSIONS
  The CUBE technique is a novel technique that allows for dissection of breast lesions with continuous visualization of margins. This facilitates real-time adjustments to ensure margin negativity. Preliminary data is promising, but further research is needed for confirmation.
authors.affiliation: Department of Surgery, University of Arkansas for Medical Sciences and the Winthrop P. Rockefeller Institute, Little Rock, AR, USA.
authors.forename: Evan
authors.initials: E
authors.lastname: Tummel
authors.forename: Richard
authors.initials: R
authors.lastname: Betzold
authors.forename: Kristalyn
authors.initials: K
authors.lastname: Gallagher
authors.forename: V Suzanne
authors.initials: VS
authors.lastname: Klimberg
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008408:Mastectomy / Q000379:methods*; D009367:Neoplasm Staging; D011379:Prognosis; D025321:Surgery, Computer-Assisted / Q000379:methods*; D018084:Ultrasonography, Interventional; D016217:Ultrasonography, Mammary