Feasibility of Intraoperative specimen mammography for margin assessment in breast conservation surgery

Abstract

PURPOSE: Breast conserving surgery (BCS) requires the establishment of adequate margins to reduce local recurrence. The purpose of this study was to determine whether intraoperative specimen mammography is effective and efficient as margin assessment method in Asian women. METHOD: A total of 182 patients who had breast cancer treated with BCS between October 2015 and September 2017 were evaluated. After wide excision, intraoperative specimen mammography was used to assess margin adequacy. Whenever the margins were close to the lesions, further resection was performed. And 4 direction frozen section analysis were done in 84 patients who were treated with BCS between January 2012 and December 2014. We compared two groups of different margin assessment methods. The margins were histologically assessed and correlated with the specimen mammographic findings. RESULTS: 61.6% patients have dense breasts (mammographic density > 50%) and 85.7% of dense breasts could margin assess by intraoperative specimen mammography. Incomplete intraoperative excision detected by specimen mammography led to immediate re-excision in 24 (13.2%) cases which were more than 13 (15.5%) cases in group of frozen section analysis (p = 0.47). Significant correlations were found between the radiological and histological margins (R2 = 0.222, p < 0.05). The operation time of frozen section analysis group were statistically significant longer than specimen mammography group (mean 108.4 and 85.2 minutes, respectively). CONCLUSION: Our results show that breast lesions intraoperative specimen mammography for BCS is useful to identify margin clearance regardless of the mammographic density.