Our Summary

This study looked at whether using images taken during surgery (intraoperative imaging) could help reduce the need for additional surgery (re-excision) in breast cancer patients. The researchers compared two groups: one where surgeons removed extra tissue based on what they could see (control group), and one where surgeons used images taken during the surgery to guide them (radiographic group). They found that using mammography (a type of X-ray used to examine the breasts) during surgery significantly reduced the need for more surgery. However, they didn’t see the same results when using ultrasound imaging. Therefore, the study suggests that using intraoperative mammography can improve patient care and reduce costs by minimizing the need for additional surgeries.

FAQs

  1. What is the importance of minimizing margin re-excision in lumpectomy procedures?
  2. How does intraoperative imaging affect the margin positivity rate in lumpectomy procedures?
  3. Can intraoperative imaging in lumpectomy procedures improve patient care and reduce costs?

Doctor’s Tip

A helpful tip a doctor might tell a patient about lumpectomy is to discuss the use of intraoperative imaging, such as mammography, to guide margin excision. This can help minimize the need for additional surgeries to achieve clear margins and optimize patient care.

Suitable For

Patients with stage O-III breast cancer who are undergoing lumpectomy are typically recommended for a lumpectomy. This study specifically focuses on patients who underwent lumpectomy for stage O-III breast cancer and evaluates the margin positivity rate in two groups: those with shave margin based on gross specimen (control group) and those with shave margin based on intraoperative imaging (radiographic group). The study found that using intraoperative imaging, such as mammography, can decrease the margin re-excision rate, thus optimizing patient care and reducing costs. Surgeons are encouraged to utilize intraoperative imaging to guide margin excision for better outcomes in breast conservation surgery.

Timeline

  • Before lumpectomy:
  1. Patient is diagnosed with stage O-III breast cancer and is recommended for lumpectomy.
  2. Patient undergoes pre-operative consultations and tests to assess their overall health and readiness for surgery.
  3. Patient may undergo imaging tests such as mammography and ultrasound to determine the extent of the tumor and plan for the lumpectomy procedure.
  • During lumpectomy:
  1. Surgeon performs lumpectomy procedure to remove the tumor while preserving as much breast tissue as possible.
  2. Intraoperative imaging, such as mammography or ultrasound, is used to guide the surgeon in ensuring clear margins around the tumor.
  3. Shave margins are taken based on either gross specimen (control group) or intraoperative imaging (radiographic group) to minimize the need for margin re-excision.
  • After lumpectomy:
  1. Pathology report is reviewed to assess margin positivity rate and determine if further re-excision is needed.
  2. Patients in the radiographic group (RG) show a statistically significant decrease in margin re-excision rate compared to the control group (CG).
  3. Surgeons are encouraged to use intraoperative imaging to guide margin excision and improve patient care while reducing costs associated with re-excision procedures.

In conclusion, the use of intraoperative imaging during lumpectomy can help optimize patient care by ensuring appropriate oncologic resection and reducing the need for costly margin re-excision procedures. Surgeons are urged to consider incorporating this technology into their practice to benefit both patients and healthcare systems.

What to Ask Your Doctor

  1. How will the lumpectomy procedure be performed?
  2. What are the potential risks and complications associated with a lumpectomy?
  3. How long is the recovery period after a lumpectomy?
  4. Will I need additional treatments, such as radiation therapy, after the lumpectomy?
  5. What is the likelihood of needing a second surgery (re-excision) to achieve clear margins?
  6. How will the margins be evaluated during the surgery to ensure they are clear of cancer cells?
  7. Will I need any imaging tests, such as mammograms or ultrasounds, before or after the lumpectomy?
  8. What is the success rate of lumpectomy in treating my specific type and stage of breast cancer?
  9. How often will I need follow-up appointments and imaging tests after the lumpectomy?
  10. Are there any lifestyle changes or precautions I should take after the lumpectomy to reduce the risk of cancer recurrence?

Reference

Authors: Larson KE, Jadeja P, Marko A, Jadeja V, Pratt D. Journal: Breast J. 2018 Sep;24(5):820-822. doi: 10.1111/tbj.13050. Epub 2018 Apr 23. PMID: 29687530