Use of intraoperative digital specimen mammography to improve operative efficiency.

Abstract

138 Background: The traditional method of confirming excision of a targeted lesion during wire localized breast biopsy has been with standard specimen mammograms (SSM). More recently, intraoperative digital specimen mammograms (IDSM) have been used to provide immediate specimen evaluation for the surgeon in the operating room. We sought to evaluate operative time with the use of IDSM versus SSM. Methods: A retrospective chart and electronic operating room record review of consecutive patients of a single breast surgical oncologist at a quaternary care academic center. Three hundred and forty-four (344) consecutive patients from 2003 to 2010 who underwent wire localized excisional biopsy or wire localized lumpectomy without lymph node evaluation, with specimen evaluation by IDSM or SSM. Operative time, defined as documented time of incision to documented time of closure, was recorded for SSM versus IDSM. Results: We compared demographics of the two groups transitioning from SSM to IDSM (Table). During the study period, median operative time decreased from 50 minutes in the SSM group to 37 minutes in the IDSM group (p<0.001). Conclusions: Operative times with the use of IDSM are significantly shorter than with SSM. Downstream effects include decreases in anesthetic time, anesthetic use, operating room charges, and increasing surgeon productivity. [Table: see text]