Advances in Intraoperative Margin Assessment for Breast Cancer

Abstract

Breast-conserving therapy including partial mastectomy and radiation is commonly performed for patients who are surgical candidates for breast cancer. Although it is as effective as mastectomy for the treatment of early breast cancer, re-excision for positive or close margins is common. This is costly, inconvenient for patients and delays initiation of adjuvant therapies. Commonly used methods for breast tumor localization and optimization of margin assessment include preoperative wire or seed localization, precise specimen orientation, specimen radiography, and cavity shaving. Unfortunately, these techniques do not assess margins on a microscopic scale in real time. Our report reviews the current and experimental techniques of intraoperative microscopic margin assessment including frozen section, cytologic imprint analysis, ultrasound, micro-CT, MarginProbe®, near-infrared imaging, and spectroscopy.