Resection Margin Research Articles

Central vascular ligation and complete mesocolon excision vs D3 lymphadenectomy: Standardization of surgical technique

Surgical advancements have transformed colorectal cancer treatment, with complete mesocolic excision (CME) becoming a crucial method to guarantee oncological safety and effectiveness. The article by Yadav emphasized the significance of CME in attaining optimal resection margins, thorough lymph node dissection, and enhanced long-term survival rates. The adjunctive function of D3 lymphadenectomy, emphasizing the clearance of lymphatic drainage along the supplying vessels, was also addressed. CME with central vascular ligation, based on the principles of total mesorectal excision for rectal cancer, entails en bloc tumor resection and precise dissection along the embryological planes, thus diminishing recurrence and improving survival rates. The viability and safety of minimally invasive techniques, such as laparoscopic CME, have been confirmed; however, technical difficulties remain owing to the intricate vascular anatomy. Robotic-assisted surgery presents potential benefits, including accurate lymphatic dissection and intracorporeal anastomosis. However, evidence demonstrating its superiority over laparoscopic techniques is scarce owing to high costs and prolonged duration. This study promotes the global standardization of CME as an essential element of modern colorectal cancer surgery. CME epitomizes contemporary oncological practices, requiring widespread adoption to achieve superiority in colon cancer management.

Abstract 5290: Spatial multi-omics defines a shared glioblastoma infiltrative signature at the resection margin

Abstract Glioblastoma (GBM) remains an untreatable disease. Understanding of GBM’s infiltrative biology at the resection margin is limited, despite causing disease recurrence and progression. To address this, we generated a high-throughput single-nucleus (sn)RNA-seq and snATAC-seq multi-omic dataset from six tumors with distinct genomic drivers and combined it with spatial transcriptomics to characterize the unique molecular phenotype of GBM near the margin. By contrasting GBM-specific biology in matching “Core” vs. “Margin” dissections, we define unique, shared “GBM infiltration” and chromatin accessibility signatures near the margin. We prioritize EGFR as a top differentially expressed and accessible “Margin” marker across GBM subtypes, show its dynamic expression along a core-to-margin infiltration trajectory, and validate its role in migration through CRISPR/Cas9 deletion in two patient-derived models. ChIP-seq studies further corroborate preferential TEAD1 binding at EGFR’s accessible regulatory elements. This validated multi-omic dataset enables further studies into tumor and microenvironment biology in the context of residual GBM disease. Citation Format: Balagopal Pai, Susana Ramos, Wan Sze Cheng, Tanvi Joshi, Gabrielle Price, Jessica Tome-Garcia, Kristin Beaumont, Robert Sebra, Raymund Yong, Elena Zaslavsky, Nadejda M. Tsankova. Spatial multi-omics defines a shared glioblastoma infiltrative signature at the resection margin [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 5290.

Silicone implant as a potential association with multifocal/multicentric breast cancer: A case report

Breast augmentation with silicone implants is a prevalent procedure worldwide, although with certain associated complications. While the current literature does not establish a direct causative relationship between implants and breast cancer, there are recognized diagnostic and therapeutic challenges posed by the presence of implants in the event of breast cancer. We report a unique case of a 37-year-old premenopausal woman with silicone breast implants who detected a palpable mass in her right breast. On further evaluation and diagnostic tests, multifocal and multicentric invasive ductal carcinoma was confirmed. Despite the complexity introduced by the presence of implants and multifocal and multicentric disease, which typically directs management towards mastectomy, a decision for breast-conserving surgery (BCS) was reached following thorough multidisciplinary consultation and pre-operative planning. The procedure was successful, with clear resection margins, no intraoperative complications, and preservation of esthetic outcomes. The long-term success of the personalized BCS approach, highlighted by the absence of local recurrence at the 3-year follow-up, underscores the importance of personalized, multidisciplinary planning in treating invasive ductal carcinoma in patients with silicone breast implants. This case underscores the need for further investigation into the potential link between silicone implants and multifocal and multicentric invasive ductal carcinoma, and reconsideration of prevailing surgical approaches to better utilize BCS.

Intersphincteric abdominoperineal resection with radical en bloc prostatectomy for synchronous or locally advanced rectal or prostate cancer.

For patients with locally advanced rectal cancer invading the prostate or prostate cancer invading the rectum a negative resection margin (R0) is the most important criterion to predict local recurrence and disease-free survival. Following neoadjuvant treatment (when indicated), pelvic exenteration is often the surgical treatment of choice in these patients, involving en bloc excision of the rectum, prostate, and bladder to ensure clear resection margins and resulting in a colostomy and ileal conduit. The surgery is most commonly performed by laparotomy. We describe an alternative less invasive option for synchronous or locally advanced rectal or prostate cancer in the form of a laparoscopic (or robotic assisted) intersphincteric abdominoperineal resection (APR) with en bloc prostatectomy and urinary reconstruction in selected patients. Patients with synchronous rectal and prostate disease or locally advanced rectal and/or prostate cancer undergoing minimally invasive intersphincteric APR with en bloc prostatectomy with urinary reconstruction were retrospectively analyzed. The primary endpoint was the proportion of negative resection margins. Secondary endpoints included complications and disease recurrence. Eleven consecutive patients were identified. All patients had negative resection margins and there were no patients with disease recurrence of either rectal or prostate cancer after a median follow-up of 26months (IQR 63). There were no same admission reoperations, two patients with a postoperative ileus and two patients with an urinary leak, of which one had a delayed leak at 7months which was repaired. Urinary incontinence rates varied, but only one patient was referred for insertion of an artificial urinary sphincter. Intersphincteric minimal invasive APR with en bloc prostatectomy is a feasible alternative to complete pelvic exenteration in selected patients with synchronous or locally advanced rectal and/or prostate cancer.

Intraoperative examination in bone and soft tissue pathology.

Intraoperative examination in bone and soft tissue pathology.

Comparison of efficacy between robotic and open hepatectomy: a systematic review and meta-analysis of propensity score-matched studies.

This meta-analysis evaluates and contrasts the diagnosis and perioperative results involving RLR (robotic liver resection) and open OLR (open liver resection). The researcher used systematic search criteria of databases including MEDLINE, PubMed, Google Scholar, and the Cochrane Library for relevant literature published between January 2000 and January 2025. Eight non-randomized controlled trials were included, each using propensity score matching (PSM), involving 1192 patients. Among them, 557 patients received robotic laparoscopic resection (RLR), while 635 patients underwent open laparoscopic resection (OLR). Undergoing RLR was found to lead to longer surgical times, according to the analysis; however, patients undergoing RLR experienced notably shorter hospital stays compared to those undergoing open liver resection. No significant variations were noted regarding blood loss between the groups, incidence of bile leakage, complication rates, R0 resection margins, or 90-day mortality. RLR demonstrates surgical results similar to those of OLR. Key advantages include shorter hospitalization times and lower complication rates.

Laparoscopic Minimally Invasive Approach for Pelvic Solitary Fibrous Tumor.

A solitary fibrous tumor (SFT) is a rare mesenchymal fibroblastic tumor characterized by intermediate behavior, with a peak incidence in the fifth and sixth decades of life. SFTs have been reported at almost every anatomic site, with approximately 20% of cases involving the abdominal cavity.1 SFTs are often asymptomatic and may be discovered as an incidental finding on imaging. Sometimes when the tumor size is large, it may produce symptoms related to pressure effects of adjacent organs.2 The standard treatment for SFTs consists of surgical resection with free resection margins. Given the rarity of SFTs, there is no global consensus for their treatment with respect to radiotherapy and adjuvant chemotherapy.3 A minimally invasive laparoscopic approach has been described in the literature, especially in cases where surgery is not extremely demolitive.4,5This report presents the case of a 66-year-old female with a preoperative diagnosis of SFT confirmed by percutaneous needle biopsy. A computed tomography scan showed a voluminous solid expansive formation in the pelvic area measuring 96× 89×92 mm, which was attached to the ipsilateral ureter and was in contact with the internal iliac artery for over 180° (Tinelli's score grade 3). 6 The patient underwent surgery consisting of laparoscopic removal of the pelvic mass, with resection and re-implantation of the ipsilateral ureter and ligation of the internal iliac vessels. Video 1 provides a step-by-step description of the surgical strategy adopted. Minimally invasive surgery is feasible in selected patients with large mesenchymal tumors and could be a viable option for optimizing the multidisciplinary approach to treating this rare tumor.

Oncological and Functional Outcomes After Minimally Invasive Surgery for Mid and Low Rectal Adenocarcinoma: A Review.

In this study, we analyze the oncological and functional outcomes after minimally invasive surgery (laparoscopic and robotic) for mid and low rectal adenocarcinoma.This is a narrative review of articles published from January 2019 to December 2024 in which we analyzed the rate of short-term oncological outcomes (quality of surgical samples), long-term oncological outcomes (recurrence rate, overall survival, and disease-free survival), and functional disorders (urinary, sexual, and bowel function) after minimally invasive surgery. The rates of complete mesorectum are 67.7%-92.8%, the rate of free circumferential resection margin is 94%-98.2%, and the rate of free distal resection margin is 99.4%-100%. The local recurrence rate is 2.3%-7.3%, the overall survival rate is 80%-95.6%, and the disease-free survival rate is 70%-86.4%. The rate of urinary disorders is 25%-26.5%, sexual disorders are 35%-80%, and bowel disorders are 17%-44.6%. This review demonstrates that minimally invasive surgery yields favorable oncological and functional outcomes. The continuous evolution in robotic surgery will increasingly lead to interesting implications for rectal surgery, thanks to less surgical trauma and better intraoperative visualization of nerves.

Multicentric Retrospective Analysis of Oncocytic Adrenocortical Carcinoma: Insights into Clinical and Management Strategies

Oncocytic adrenocortical carcinoma (OAC) is a rare variant of conventional adrenocortical carcinoma (ACC), characterized by oncocytic tumor cells comprising more than 90% of the tumor. Due to its rarity, there is a lack of reliable data on the clinicopathological features and outcomes of OAC. The aim of this study was to assess the clinical presentation, treatment modalities, and outcomes of patients with OAC, comparing these results with a cohort of patients with conventional ACC. Data from 9 referral centers in Italy on 44 patients with OAC were retrospectively analyzed and compared with data from 145 patients with conventional ACC. Patients with OAC had a smaller median tumor size, more favorable resection margin status, and lower incidences of venous invasion and persistent/recurrent disease during follow-up. Additionally, patients with OAC exhibited longer times to progression (TTP) and overall survival (OS) compared to patients with conventional ACC. Multivariable analyses identified Ki67 and tumor size as features independently associated with disease progression during post-surgical follow-up, while Ki67 and distant metastases at diagnosis were independently associated with OS in OAC patients. After complete tumor removal, the risk of recurrent disease was higher in patients with either Ki67 ≥ 20% or ENSAT stage III/IV. OAC appears to have a more indolent clinical course and better prognosis than conventional ACC. Similar to conventional ACC, Ki67 remains a significant prognostic marker for OAC and, along with ENSAT stage, serves as a reliable biomarker for identifying patients who may benefit from adjuvant mitotane therapy.

An International Multicentre Retrospective Cohort Study Evaluating Robot-Assisted Total Mesorectal Excision in Experienced Dutch, French, and United Kingdom Centres—The EUREKA Collaborative

Background: Robot-assisted total mesorectal excision has been proposed as an alternative to laparoscopic TME for rectal cancer. However, its short-term outcomes and long-term oncological efficacy remain debated, especially in Western populations. This study evaluates the short-term clinical and long-term oncological outcomes of robot-assisted total mesorectal excision performed by experienced surgeons in high-volume European centres. Methods: This multicentre, international, retrospective cohort study included 1390 patients from the EUREKA collaborative dataset who underwent robot-assisted total mesorectal excision for rectal cancer between January 2013 and January 2022. All surgeries were performed by expert surgeons beyond the learning curve. Data were analysed for patient demographics, perioperative outcomes, pathological findings, and three-year survival metrics. Kaplan–Meier analysis was used to evaluate overall and disease-free survival. Results: Of 1390 patients, 60.6% underwent restorative low anterior resection. Conversion to open surgery occurred in 3.7%, and postoperative complications were reported in 28.7%. Anastomotic leakage occurred in 14.7% of patients who underwent restorative low anterior resection. The median operative time was 223 min. R0 resection was achieved in 94.7%, and circumferential resection margin positivity was 5.5%. Three-year overall survival was 90.1%, disease-free survival was 88.6%, and local recurrence was 2.9%. Conclusions: Robot-assisted total mesorectal excision performed by experienced surgeons in high-volume European centres is safe, with low conversion rates, acceptable complication rates, and favourable oncological outcomes. These findings underscore the potential of robot-assisted total mesorectal excision as a standard approach for rectal cancer in specialised settings.

Comparing tonsillectomy vs tonsil biopsy in the diagnosis of palatine tonsil squamous cell carcinoma - a retrospective analysis of subsequent resection margins.

Comparing tonsillectomy vs tonsil biopsy in the diagnosis of palatine tonsil squamous cell carcinoma - a retrospective analysis of subsequent resection margins.

Outcomes associated with large loop excision of the cervical transformation zone in women 60–64 years of age: A population‐based register study from Denmark

AbstractIntroductionFor women treated for cervical dysplasia at 60–64 years in Denmark, we reported the frequency of abnormalities before and after treatment of cervix uteri (most frequently performed as large loop excision of the cervical transformation zone, LLETZ) using population‐based real‐world data.Material and MethodsWe conducted a retrospective cohort study based on national data from the Danish Pathology Data Bank and identified women who underwent a LLETZ in 2010–2016 at the age of 60–64. Women were managed according to nationwide evidence‐based recommendations proposed by the Danish professional organizations. We retrieved information on all LLETZ specimens, cervical histology, cytology, and human papillomavirus (HPV) tests in the period of 2 years prior to the procedure to 2 years thereafter. We reported the frequencies of abnormalities before, at, or after the procedure.ResultsOf the 1014 women who had a LLETZ during the study period, 660 (65%) showed cervical intraepithelial neoplasia grade 1 or worse (CIN1+, including CIN1, CIN2, CIN3, cervical cancer, and CIN not otherwise specified) in their LLETZ specimen, with free resection margins in 255 (39%). Of the 1014 women, 551 (54%) had CIN2+ in a biopsy preceding the LLETZ and in 567 (56%) CIN2+ was found in their LLETZ specimen. In 37 (4%) women, the specimen showed cervical cancer; whereas in the pre‐LLETZ biopsies of these 37 women, cancer was detected in only 7 (1%). After LLETZ, 818 (81%) women underwent test‐of‐cure follow‐up which was positive in 406 women (40%). Furthermore, 408 (40%) women had new histological samples registered after LLETZ. These showed CIN2+ in 134 (13%) women, whereas a new cancer was diagnosed in 11 (1%) women.ConclusionsDue to persistent abnormal tests after LLETZ, an extended follow‐up is still required for a large proportion of the women in this age group.

Frozen section pathology in IPMN: A systematic review

AbstractIntraductal papillary mucinous neoplasms (IPMNs) resection margins are assessed intraoperatively using frozen section (IFS) pathology. We conducted a systematic review to evaluate the concordance of IFS with permanent histopathology and the association between IFS margin status and recurrence. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. We queried PubMed, Embase, Scopus, and Google Scholar for studies reporting IFS in patients undergoing resection for IPMN. Data, including IFS margin status, recurrence rates, and final pathology, were extracted. Positive margins were defined as high‐grade dysplasia or invasive cancer. Seven studies, with a total of 706 patients, met the inclusion criteria. Positive IFS margins were reported in 9.4% of cases, with a high correlation (98%) between IFS and final pathology. Recurrence occurred in 15.4% of patients. Fifty‐nine of 85 (69.4%) patients with recurrence of IPMN or intraductal papillary mucinous carcinoma (IPMC) had negative IFS margins. IFS accurately predicts final pathology and is a valuable tool for guiding intraoperative decision‐making. A sizeable number of patients experienced recurrence despite negative margins, highlighting the need for adjunct diagnostic modalities and continued surveillance following resection, regardless of margin status.

Targeting therapeutic nanoparticles to the glioblastoma resection margin by harnessing post-operative spatiotemporal blood-brain barrier disruption.

Resection surgery is the first-line therapy for glioblastoma (GBM) that is performed in >70% of patients, typically within days of suspected diagnosis. Current protocols for follow-on chemoradiotherapy have shown only modest efficacy in eliminating residual disease, leading to inevitable tumour recurrence. There remains a need for new approaches to swiftly and effectively treat post-operative residual disease to prevent the rapid early progression of recurrent GBM. Using syngeneic preclinical models of glioblastoma resection, we identified a spatially and temporally restricted window of blood brain barrier (BBB) disruption localised to the resection margin, during the immediate (15 min) and early (48-72h) postoperative periods. Intravenous administration of fluorescently labelled, clinically-used liposome nanoparticles during these periods demonstrated that selective accumulation at the postoperative resection margin, while largely being excluded from areas of the brain with an intact BBB, could be achieved. Confocal analysis confirmed the presence of extravasated nanoparticles within the margin parenchyma which largely interacted with microglial populations closely associated with residual tumour cells. Exploiting this, we performed intravenous administration of doxorubicin-loaded liposomes (DOX-Lipo) coinciding with the peak of postoperative BBB disruption and demonstrated both enhanced chemotherapy delivery and consequently complete inhibition of tumour recurrence from a single administration. Overall, this work underscores the importance of timing concomitant chemotherapy to the post-operative timeframe and demonstrates that clinically-used liposomal nanomedicines could be readily repurposed for early post-operative therapy in aggressive brain tumours.

Surgical Management of Sacral Bone Tumors: A Retrospective Analysis of Outcomes, Complications, and Survival.

Background: Primary malignant bone tumors are exceedingly rare, with an incidence of 0.5 to 1 per million, and sacral localization is even more uncommon, representing only 1-3.5% of these tumors. These malignancies are often diagnosed late due to their asymptomatic nature until they present as large, advanced intrapelvic tumors. Management is complicated by the need for precise surgical intervention and the consideration of adjuvant therapies based on tumor histology and patient factors. Methods: We conducted a single-center, retrospective analysis of patients who underwent complete, partial, or hemisacrectomy for primary malignant bone tumors or recurrent sacral metastases. Excluded were patients with metastatic disease not necessitating sacrectomy. Data collected included demographics, clinical characteristics, tumor types, resection status, adjuvant therapies, recurrence, metastasis, and complications. Surgical approaches were categorized as posterior, anterior, or combined anterior-posterior. The primary outcomes were overall survival and disease-free survival, while the secondary outcomes focused on complication rates and functional outcomes. Results: The study included 19 patients (7 females, 12 males) with a mean age of 48.9 years at the time of surgery. Primary malignancies were present in 90% of patients. Surgical approaches varied: 20% underwent double access and 5% anterior access only, and the remainder had posterior approaches. High partial sacrectomy (above S3) was performed in 20%, while low sacrectomy (at or below S3) was performed in 80%. Complete resection with clean margins (R0) was achieved in 65% of cases, while 35% had R1 resections with microscopic tumor remnants. Root resection was necessary in 25% of patients. Local recurrence occurred in 25% of patients, with two requiring reoperation and neurological sacrifice. Distant metastases were observed in 20% of cases. Postoperative complications affected 60% of patients. The most common issues were surgical wound dehiscence with delayed healing (35%) and visceral changes affecting the bowel and urination (25%). No mechanical complications were reported. Conclusions: Sacrectomy remains a challenging procedure with substantial morbidity and variability in outcomes. The choice of surgical approach-posterior, anterior, or combined-depends on tumor location and extent. While posterior-only approaches are often preferred for lower sacral lesions, combined approaches may be necessary for more extensive tumors. Survival and disease-free survival rates are influenced by resection margins and the biological behavior of the tumor. Wide-margin resections (R0) are associated with lower local recurrence rates but do not eliminate the risk of distant metastases.

The impact of resection margin status according to lymph node metastasis on the survival outcome of perihilar cholangiocarcinoma.

The impact of resection margin status according to lymph node metastasis on the survival outcome of perihilar cholangiocarcinoma.

Prospective cohort study of Suture-Line recurrence and clinical outcomes in stage 1A Non-Small cell lung cancer.

Prospective cohort study of Suture-Line recurrence and clinical outcomes in stage 1A Non-Small cell lung cancer.

801 Biodegradable Polyurethane Matrix (BPM) in Small Scale Reconstruction of Malignant Resections in Functional Areas

Abstract Introduction Biodegradable Polyurethane Matrix (BPM) are temporary, biocompatible scaffolds that support tissue regeneration in surgical defects while reducing the need for permanent solutions. Spiradenomas, benign skin tumors from sweat gland cells, often require surgical removal, which can lead to scarring, particularly around joints like the ankle. Preliminary studies show BPMs may be effective in managing defects from malignant resections in critical areas, but their role in resection margins is still an emerging area needing further investigation. Methods This case report presents the successful application of a BPM in the reconstruction of a soft tissue defect following wide local excision of a spiradenoma on the right ankle of a 64-year-old male patient, demonstrating the value of these matrices as an essential reconstructive tool in the management of soft tissue defects following malignant resections. Results Follow up evaluations showed good graft take of the split-thickness skin graft with good interval healing and smooth contour restoration. Importantly, the patient maintained full range of motion in the right ankle joint, thus highlighting the successful preservation of function in this critical area. Some minor hypergranulation tissue was observed and subsequently treated with silver nitrate. The use of BPM provided reliable and robust soft tissue coverage with optimal functional and aesthetic outcomes and minimal donor site morbidity when compared to skin grafting outcomes alone. Conclusions Overall, the use of BPM in this case of spiradenoma excision and subsequent wide local resection in a functional area of the ankle provided robust soft tissue coverage while enabling excellent functional recovery and cosmetic outcomes. The minimal donor site morbidity associated with this approach also further highlights its advantages over traditional skin grafting techniques. The successful application of BPMs in functional areas illustrates their value as an essential reconstructive in the management of soft tissue defects following potentially malignant/malignant resections. Applicability of Research to Practice BPMs provide an effective temporary solution for wound healing, as demonstrated in a case where they facilitated skin grafting after wide excision. This approach led to successful graft integration and excellent functional recovery, allowing the patient full ankle mobility. Their ability to preserve function during healing is crucial in joint areas, minimizing complications and enhancing quality of life. Additionally, BPMs reduce donor site morbidity, leading to less discomfort compared to larger graft sites while promoting better healing and mobility outcomes. Funding for the Study N/A

Pathologically Tumor-free Resection Margin Distance as a Surrogate Parameter in Primary Vulvar Squamous Cell Cancer: Analysis of a Large Two-Center Patient Cohort.

This study evaluated the role of tumor-free margin distances and other prognostic factors, including age, lymph-node metastases, lymphatic vessel invasion, and local recurrence, on the survival of patients with vulvar squamous cell carcinoma (VSCC) undergoing primary surgical treatment. A retrospective analysis reviewed the records of 232 VSCC patients who had undergone primary radical local excision with R0 resection between 2009 and 2021 at ANregiomed Hospital Ansbach and Erlangen University Hospital (Germany). Patients, aged 18 and older with no distant metastases, were grouped by resection margin distances (1 to ≤3mm, 3 to ≤8mm, >8mm) for survival analysis using the Kaplan-Meier and log-rank tests. A Cox proportional hazards regression model incorporating multiple covariates, selected using the best-subset selection method and guided by the Akaike information criterion (AIC), was used. In the next step, we conducted a separate analysis of the patients who experienced a local recurrence. The median age of the 232 patients analyzed was 69years, with a median follow-up period of 10.5years; 82 patients died. Survival varied significantly relative to resection margin distance (p=0.0022), with the highest rates in the 1 to ≤3mm group and the lowest in the >8mm group. Multivariate analysis revealed that age, lymphatic vessel invasion, and resection margin distance significantly influenced survival, with higher values associated with increased mortality. Out of 232 patients analyzed, 43 developed a local recurrence. In the group with resection margins of 1 to ≤3mm, 37% of patients experienced a local recurrence. Among those with margins of 3 to ≤8mm, 44% had a recurrence, while only 19% of patients with margins >8mm showed a local recurrence. The study underscored the significance of tumor-free margin distance as a surrogate marker for survival in VSCC patients. In addition to lymphatic vessel invasion as the most critical prognostic factor, tumor-free resection margin distance and age emerged as significant predictors of overall survival. The findings advocate for tailored, function-preserving surgical approaches to improve patient outcomes.

Intraoperative ultrasound-guided breast-conserving surgery: A performance analysis on the basis of novel cancer lesion classification and patients' cosmetic satisfaction.

Intraoperative ultrasound-guided breast-conserving surgery: A performance analysis on the basis of novel cancer lesion classification and patients' cosmetic satisfaction.