Scientific paperThe pancake phenomenon contributes to the inaccuracy of margin assessment in patients with breast cancer
Section snippets
Methods
Between October 31, 2000, and July 23, 2001, all patients undergoing needle localization for excision of impalpable breast lesions were entered into this study. After surgical excision of the involved tissue, the operating surgeon measured the length, width, and height of each specimen. The specimen was then placed on a flat tray and brought immediately to the mammography department for specimen radiography.
The original mammogram was reviewed in advance to determine whether compression was
Results
Ninety-six consecutive patients underwent 100 consecutive breast biopsies—specifically, needle localization and excision of impalpable breast lesions. The median age of the patients was 51 years (range 30 to 83). Two patients underwent simultaneous excision of two separate impalpable breast lesions. Two patients underwent sequential excision of an impalpable breast lesion after a failed biopsy. All procedures were performed by one of two dedicated breast surgeons.
The mean size of the original
Comments
The role of margin assessment remains critical in determining the outcome of patients with both in situ and invasive breast cancers treated with breast conservation therapy. Results from several recent studies have shown that positive microscopic margins are associated with a significantly higher rate of local recurrence than those with negative margins [8], [9], [10]. Moreover, the extent of margin involvement is similarly important, with recurrence being higher for patients with extensive
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2021, Clinical ImagingCitation Excerpt :This value is higher than our R2 value of 0.026 for the minimal margin, but even an R2 value of 0.33 is still not useful for daily practice. This poor correlation between the radiographic and histopathological margin distances might be explained by the “pancake phenomena” of SR, which results in changes in specimen height and volume of up to 50% due to compression or gravity during SR [27,29,30]. The results of current study regarding the poor accuracy of SR in RSL in predicting margin status are also in accordance with the results reported in WGL studies.