title: Achieving clear margins. Directed shaving using MarginProbe, as compared to a full cavity shave approach.
abstract: BACKGROUND
  Following lumpectomy, full cavity shaving approach is used to reduce positive margin rates, among other issues previously studied by others, at an expense of increase in tissue volume removed. We present our experience after switching from full cavity shaving to a targeted shaving approach using MarginProbe, an intra-operative margin assessment device.
  
  
  METHODS
  Specimen excision was performed according to standard of care. Additional shavings were taken based on device readings on the lumpectomy specimen. Intra-operative imaging was used, as required.
  
  
  RESULTS
  We compared 137 MarginProbe cases to 199 full cavity shave cases. The re-excision rate was reduced by 57% (P = 0.026), from 15.1% to 6.6%. The overall tissue volume removed was reduced by 32% (P = 0.0023), from 115 cc to 78 cc.
  
  
  CONCLUSIONS
  MarginProbe enabled a change in the lumpectomy technique from full cavity shavings to directed shavings guided by the device. There was a significant reduction in re-excisions and in the overall tissue volume removed.The lower amount of shavings also contributed to a reduction in pathology work.
authors.affiliation: University of Iowa Hospital and Clinics, 200 Hawkins Dr., Iowa City, IA 52242, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Coble
authors.affiliation: University of Iowa Hospital and Clinics, 200 Hawkins Dr., Iowa City, IA 52242, USA; Hall-Perrine Cancer Center: Mercy Hospital, 701 10th St, Cedar Rapids, IA 52403, USA. Electronic address: vreid@mercycare.org.
authors.forename: Vincent
authors.initials: V
authors.lastname: Reid
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000295:instrumentation*; D000072662:Margins of Excision; D015412:Mastectomy, Segmental / Q000295:instrumentation*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D018365:Neoplasm, Residual / Q000517:prevention & control; D012189:Retrospective Studies; D013057:Spectrum Analysis / Q000295:instrumentation