Abstract
BackgroundThe purpose of this study was to evaluate ultrasound-guided surgery for palpable breast cancer by comparing the standard palpation-guided surgery in terms of the extent of healthy breast tissue resection, the percentage of tumor-free margins, and cosmetic outcomes.MethodsThis was a prospective, observational cohort study conducted from January 2009 to July 2011. Breast cancer patients, diagnosed via biopsy, were operated in guidance with either ultrasound or palpation. Patient demographics, tumor features, intraoperative findings, pathologic and cosmetic results, intraoperative-measured ultrasound margins, and pathology margins were compared.ResultsUltrasound (US)-guided lumpectomy was performed on 84 women and palpation-guided lumpectomy on 80 women. Patient demographics and tumor characteristics showed no differences. The rate of re-excision was 17 % for the palpation-guided surgery group, and 6 % for the US-guided group (p = 0.03). There was good correlation between the closest margins recorded by US and pathology margins (r = 0.76, p = 0.01). Volume of resection was significantly larger in the palpation-guided group despite the similar size of tumors (p = 0.048). Cosmetic outcome of surgery was equivalent between groups.ConclusionsIntraoperative ultrasound guidance for excision of palpable breast cancers is feasible and gives results in terms of pathologic margins that are comparable with those achieved by standard palpation-guided excisions.
Highlights
The purpose of this study was to evaluate ultrasound-guided surgery for palpable breast cancer by comparing the standard palpation-guided surgery in terms of the extent of healthy breast tissue resection, the percentage of tumor-free margins, and cosmetic outcomes
Local recurrence risk is reduced by wider tissue excision, cosmetic results are adversely affected by more extensive operations
The study was designed in two groups for palpable breast cancer, US-guided lumpectomy group and palpation-guided lumpectomy group which consisted of consecutive 84 and 80 patients, respectively
Summary
The purpose of this study was to evaluate ultrasound-guided surgery for palpable breast cancer by comparing the standard palpation-guided surgery in terms of the extent of healthy breast tissue resection, the percentage of tumor-free margins, and cosmetic outcomes. With improvement in detection of breast cancer at an earlier stage, more breast cancers are being detected at a smaller size. This makes breast conservation surgery (BCS) a feasible and preferred option for many women diagnosed with early-stage breast cancer. Local recurrence after BCS is related to patient age, tumor size and grade, and presence of multifocal or multicentric disease [1,2,3]. Evaluation of the resection margins is commonly undertaken as an aid to achieve an optimal
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