High-frequency ultrasound (20–80 MHz) for analyzing breast cancer surgical margins: A 73-patient clinical study

Abstract

Results from a 2010 pilot study indicate that the peak densities of high-frequency (HF) ultrasonic spectra (20–80 MHz) correlate to a wide range of margin pathologies from breast conservation surgery (BCS). Utah Valley University and the Huntsman Cancer Institute conducted a follow-up study to determine the sensitivity and specificity of HF ultrasound for differentiating malignant from nonmalignant tissue in BCS margins. A 73-patient blind study was performed with conventional pathology used as the gold standard. A total of 492 specimens were ultrasonically tested ex vivo and then sent to pathology for analysis. The margins were approximately 3x20x20 mm, with each sampled at 2–5 locations. The data were analyzed for malignancy using peak density. Results from the current study indicate that peak density can differentiate malignant from nonmalignant pathologies with an accuracy of 73.8%. Trends from the pilot study closely resemble this study’s results. Application of these trends to the current study predicts that a multivariate analysis will yield much higher accuracy (84.1%), specificity (85.2%), and sensitivity (77.6%) values. The results show that HF ultrasound can provide rapid, intraoperative evaluation of surgical margins, thereby increasing the quality and efficacy of breast cancer surgery. [Funding provided by the Elsa U. Pardee Foundation.]