title: Role of specimen US for predicting resection margin status in breast conserving therapy.
abstract: OBJECTIVE
  To assess the diagnostic accuracy of specimen ultrasound (US) for predicting resection margin status in women undergoing breast conserving therapy for US-detected cancer, having the histological findings as the reference standard.
  
  
  METHODS
  A total of 132 consecutive patients (age range, 34-87 years; mean, 51 years) underwent breast-conserving surgery for US-detected invasive breast cancer. All surgical specimens underwent US examination. The presence of lesion within the specimen and its distance from the specimen margins were assessed considering a threshold distance between the lesion and specimen margins of 10 mm. US findings were then compared with the pathological ones and specimen US. Sensitivity, specificity, diagnostic accuracy, positive (PPV) and negative predictive values (NPV) for predicting histological margin status were evaluated, having the histological findings as the reference standard.
  
  
  RESULTS
  The histological examination detected invasive ductal carcinoma in 96/132 (73%) cases, invasive lobular carcinoma in 32/132 (24%), mucinous carcinoma in 4/132 (3%). The pathological margin analysis revealed 96/132 (73%) negative margins and 36 (27%) close/positive margins. US examination detected all 132 breast lesions within the surgical specimens. 110 (83%) negative margins and 22 (17%) positive margins were found on US. Sensitivity, specificity, diagnostic accuracy, PPV and NPV of 44%, 94%, 80%, 73% and 82%, respectively, were found for specimen US.
  
  
  CONCLUSIONS
  Specimen US represents a time and cost saving imaging tool for evaluating the presence of US detected-breast lesion within surgical specimen and for predicting the histological margin status.
authors.forename: M
authors.initials: M
authors.lastname: Moschetta
authors.forename: M
authors.initials: M
authors.lastname: Telegrafo
authors.forename: T
authors.initials: T
authors.lastname: Introna
authors.forename: L
authors.initials: L
authors.lastname: Coi
authors.forename: L
authors.initials: L
authors.lastname: Rella
authors.forename: V
authors.initials: V
authors.lastname: Ranieri
authors.forename: A
authors.initials: A
authors.lastname: Cirili
authors.forename: A A
authors.initials: AA
authors.lastname: Stabile Ianora
authors.forename: G
authors.initials: G
authors.lastname: Angelelli
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D015412:Mastectomy, Segmental / Q000379:methods; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014463:Ultrasonography