Erschienen in:
16.03.2020 | ASO Author Reflections
ASO Author Reflections: Image-Guided Margin Assessment for Breast Cancer
verfasst von:
Barbara L. Smith, MD, PhD, Bridget N. Kelly, BA, Michele A. Gadd, MD
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 6/2020
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Excerpt
Safe lumpectomy surgery for breast cancer requires complete excision of tumor to achieve microscopically tumor-free margins. Initially, excision of breast cancers was guided by palpation, with a rim of grossly normal tissue taken around the palpable mass. Breast imaging now identifies non-palpable extensions and satellites of palpable cancers, and finds small non-palpable tumors. Marker localization and intraoperative specimen mammography now guide excision of the non-palpable lesions. Some sites use intraoperative frozen section testing of margins, but this is not widely available, prolongs surgery, and examines only a tiny fraction of the lumpectomy surface. Unfortunately, using current tools, and even with an additional shaved cavity margin excision, 10–40% of lumpectomies have positive margins that require a second surgical procedure.
1 When ‘clean’ margins have been obtained, radiation is still required, as local recurrence rates are as high as 40% with lumpectomy alone.
2 Better tools for identifying and removing residual tumor during surgery are needed. …