title: Navigated Breast Tumor Excision Using Electromagnetically Tracked Ultrasound and Surgical Instruments.
abstract: OBJECTIVE
  Lumpectomy, breast conserving tumor excision, is the standard surgical treatment in early stage breast cancer. A common problem with lumpectomy is that the tumor may not be completely excised, and additional surgery becomes necessary. We investigated if a surgical navigation system using intraoperative ultrasound improves the outcomes of lumpectomy and if such a system can be implemented in the clinical environment.
  
  
  METHODS
  Position sensors were applied on the tumor localization needle, the ultrasound probe, and the cautery, and 3-D navigation views were generated using real-time tracking information. The system was tested against standard wire-localization procedures on phantom breast models by eight surgical residents. Clinical safety and feasibility was tested in six palpable tumor patients undergoing lumpectomy by two experienced surgical oncologists.
  
  
  RESULTS
  Navigation resulted in significantly less tissue excised compared to control procedures (10.3 ± 4.4 versus 18.6 ± 8.7 g, p = 0.01) and lower number of tumor-positive margins (1/8 versus 4/8) in the phantom experiments. Excision-tumor distance was also more consistently outside the tumor margins with navigation in phantoms. The navigation system has been successfully integrated in an operating room, and user experience was rated positively by surgical oncologists.
  
  
  CONCLUSIONS
  Electromagnetic navigation may improve the outcomes of lumpectomy by making the tumor excision more accurate.
  
  
  CONCLUSIONS
  Breast cancer is the most common cancer in women, and lumpectomy is its first choice treatment. Therefore, the improvement of lumpectomy outcomes has a significant impact on a large patient population.
authors: Tamas
authors: T
authors: Ungi
authors: Gabrielle
authors: G
authors: Gauvin
authors: Andras
authors: A
authors: Lasso
authors: Caitlin T
authors: CT
authors: Yeo
authors: Padina
authors: P
authors: Pezeshki
authors: Thomas
authors: T
authors: Vaughan
authors: Kaci
authors: K
authors: Carter
authors: John
authors: J
authors: Rudan
authors: C Jay
authors: CJ
authors: Engel
authors: Gabor
authors: G
authors: Fichtinger
mesh_terms: D001940:Breast / Q000000981:diagnostic imaging; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006801:Humans; D008954:Models, Biological; D019047:Phantoms, Imaging; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D014463:Ultrasonography / Q000295:instrumentation / Q000379:methods*