Improving breast conserving surgery using the Faxitron™ OR Specimen Radiography System - complication analysis, cost evaluation and literature review

2020 ◽  
Author(s):  
C Eichler ◽  
A Westerhoff ◽  
M Warm ◽  
J Puppe ◽  
B Krug ◽  
...  
Keyword(s):  
Literature Review ◽  
Breast Conserving Surgery ◽  
Cost Evaluation ◽  
Radiography System ◽  
Specimen Radiography

scholarly journals Re-Excision Rates in Breast-Conserving Surgery for Invasive Breast Cancer after Neoadjuvant Chemotherapy with and without the Use of a Radiopaque Tissue Transfer and X-ray System

Breast Care ◽  
2018 ◽  
Vol 14 (5) ◽  
pp. 302-307
Author(s):  
Suniza Jamaris ◽  
Leyla Akpolat-Basci ◽  
Miltiades Stephanou ◽  
Sarah Wetzig ◽  
Yueksel Cubuk ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Invasive Breast Cancer ◽  
Breast Conserving Surgery ◽  
Control Group ◽  
Study Group ◽  
Transfer System ◽  
Tissue Transfer ◽  
Resected Tissue ◽  
Specimen Radiography

Background: Significant re-excision rates in breast-conserving surgery (BCS) after neoadjuvant systemic chemotherapy may result from difficulties in defining the surgical target particularly in cases with excellent treatment response. Devices allowing an exact topographic localisation of the lesion in the resected tissue could reduce re-excision rates by optimising the intraoperative detection of involved margins. Methods: 80 patients with invasive breast cancer receiving BCS after neoadjuvant chemotherapy were included in this non-randomized case-control study. 40 patients with specimen radiography performed in a standard approach (control group) were compared to 40 patients with use of a radiopaque tissue transfer system (study group). Results: 19/80 (23.75%) patients required re-excision because of involved margins; among those, 14/40 (35%) were in the control group and 5/40 (12.5%) in the study group. The association between the use of the radiopaque tissue transfer system and the lower re-excision rate was statistically significant (p = 0.023). Conclusion: Our analysis provides a rationale for the routine use of a radiopaque tissue transfer system for specimen radiography in BCS after neoadjuvant chemotherapy for invasive breast cancer in order to reduce re-excision rates.

scholarly journals Lipofilling after breast conserving surgery: a comprehensive literature review investigating its oncologic safety

Gland Surgery ◽  
2019 ◽  
Vol 8 (5) ◽  
pp. 569-580 ◽  
Author(s):  
Stephanie Cohen ◽  
Yurie Sekigami ◽  
Theresa Schwartz ◽  
Albert Losken ◽  
Julie Margenthaler ◽  
...  
Keyword(s):  
Literature Review ◽  
Breast Conserving Surgery ◽  
Comprehensive Literature Review

Feasibility of the membrane bioreactor process for water reclamation

2001 ◽  
Vol 43 (10) ◽  
pp. 203-209 ◽  
Author(s):  
S. Adham ◽  
P. Gagliardo ◽  
L. Boulos ◽  
J. Oppenheimer ◽  
R. Trussell
Keyword(s):  
Literature Review ◽  
Activated Sludge ◽  
Membrane Bioreactor ◽  
Cost Evaluation ◽  
Water Reclamation ◽  
Activated Sludge Process ◽  
Conventional Activated Sludge ◽  
In Series ◽  
Volumetric Loading ◽  
Conventional Activated Sludge Process

The feasibility of the membrane bioreactor (MBR) process for water reclamation was studied. Process evaluation was based on the following: literature review of MBRs, worldwide survey of MBRs, and preliminary costs estimates. The literature review and the survey have shown that the MBR process offers several benefits over the conventional activated sludge process, including: smaller space and reactor requirements, better effluent water quality, disinfection, increased volumetric loading, and less sludge production. The MBR process can exist in two different configurations, one with the low-pressure membrane modules replacing the clarifier downstream the bioreactor (in series), and the second with the membranes submerged within the bioreactor. Four major companies are currently marketing MBRs while many other companies are also in the process of developing new MBRs. The MBR process operates in a considerably different range of parameters than the conventional activated sludge process. The preliminary cost evaluation has shown that the MBR process is cost competitive with other conventional wastewater treatment processes.

Processing Stereotactic Breast Biopsy Specimens: Impact of Specimen Radiography System on Workflow

2013 ◽  
Vol 19 (4) ◽  
pp. 455-456 ◽  
Author(s):  
Elizabeth A. Krupinski ◽  
Marisa Borders ◽  
Kimberly Fitzpatrick
Keyword(s):  
Breast Biopsy ◽  
Biopsy Specimens ◽  
Radiography System ◽  
Stereotactic Breast Biopsy ◽  
Specimen Radiography

Does Conventional Specimen Radiography After Neoadjuvant Chemotherapy of Breast Cancer Help To Reduce The Rate of Second Surgeries?

2021 ◽  
Author(s):  
Benedikt Schaefgen ◽  
Annika Funk ◽  
Peter Sinn ◽  
Thomas Bruckner ◽  
Christina Gomez Andreu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
False Negative ◽  
Positive Margin ◽  
Complete Response ◽  
Breast Conserving Surgery ◽  
Target Lesion ◽  
Number Needed To Treat ◽  
Positive Margins ◽  
Specimen Radiography

Abstract PurposeThis is the first study to systematically evaluate the diagnostic accuracy of intraoperative specimen radiography on margin level and its potential to reduce second surgeries in patients treated with neoadjuvant chemotherapy. MethodsThis retrospective study included 174 cases receiving breast conserving surgery (BCS) after neoadjuvant chemotherapy (NACT) of primary breast cancer. Conventional specimen radiography (CSR) was performed to assess potential margin infiltration of the target lesion and recommend an intraoperative re-excision of any radiologically positive margin. The histological workup of the specimen served as gold standard for the evaluation of the accuracy of CSR and the potential reduction of second surgeries by CSR-guided re-excisions. A subgroup analysis was performed for patients with and without clinical complete response. Results 1044 margins were assessed. Of 47 (4.5%) histopathological positive margins, CSR identified 9 correctly (true positive). 38 infiltrated margins were missed (false negative). This resulted in a sensitivity of 19.2%, a specificity of 89.2%, a PPV of 7.7% and a NPV of 95.9%. The rate of secondary procedures was reduced from 23 to 16 with a number needed to treat (NNT) of CSR guided intraoperative re-excisions of 25. In the subgroup of patients with cCR, the prevalence of positive margins was 10/510 (2.0%), PPV was 1.9% and the NNT was 85. ConclusionPositive margins after NACT are rare and CSR has only a low sensitivity to detect them. Thus, the rate of secondary surgeries cannot be significantly reduced by recommending targeted re-excisions, especially in cases with cCR.

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