scholarly journals Preoperative Localization and Surgical Margins in Conservative Breast Surgery

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
F. Corsi ◽  
L. Sorrentino ◽  
D. Bossi ◽  
A. Sartani ◽  
D. Foschi
Keyword(s):  
Frozen Section ◽  
Breast Conserving Surgery ◽  
Surgical Margins ◽  
Preoperative Localization ◽  
Margin Assessment ◽  
Biological Behaviour ◽  
Frozen Section Analysis ◽  
Assessment Techniques ◽  
Definition Of ◽  
Single Technique

Breast-conserving surgery (BCS) is the treatment of choice for early breast cancer. The adequacy of surgical margins (SM) is a crucial issue for adjusting the volume of excision and for avoiding local recurrences, although the precise definition of an adequate margins width remains controversial. Moreover, other factors such as the biological behaviour of the tumor and subsequent proper systemic therapies may influence the local recurrence rate (LRR). However, a successful BCS requires preoperative localization techniques or margin assessment techniques. Carbon marking, wire-guided, biopsy clips, radio-guided, ultrasound-guided, frozen section analysis, imprint cytology, and cavity shave margins are commonly used, but from the literature review, no single technique proved to be better among the various ones. Thus, an association of two or more methods could result in a decrease in rates of involved margins. Each institute should adopt its most congenial techniques, based on the senologic equipe experience, skills, and technologies.

Utility of intraoperative frozen section analysis of surgical margins in region of neurovascular bundles at radical prostatectomy

Urology ◽  
2002 ◽  
Vol 59 (5) ◽  
pp. 709-714 ◽  
Author(s):  
Reza Z Goharderakhshan ◽  
Daniel Sudilovsky ◽  
Lauren A Carroll ◽  
Gary D Grossfeld ◽  
Richard Marn ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Frozen Section ◽  
Surgical Margins ◽  
Intraoperative Frozen Section ◽  
Frozen Section Analysis ◽  
Section Analysis ◽  
Neurovascular Bundles

Is intraoperative frozen section analysis an efficient way to reduce positive surgical margins?

Urology ◽  
2005 ◽  
Vol 66 (6) ◽  
pp. 1287-1291 ◽  
Author(s):  
Toshiki Tsuboi ◽  
Makoto Ohori ◽  
Kentaro Kuroiwa ◽  
Victor E. Reuter ◽  
Michael W. Kattan ◽  
...  
Keyword(s):  
Frozen Section ◽  
Surgical Margins ◽  
Positive Surgical Margins ◽  
Intraoperative Frozen Section ◽  
Frozen Section Analysis ◽  
Section Analysis

Optimizing Clinical Management of Surgical Margins in Breast-Conserving Therapy for Breast Cancer

2013 ◽  
pp. 66-71
Author(s):  
Stephen R. Grobmyer ◽  
Michael S. Cowher ◽  
Joseph P. Crowe
Keyword(s):  
Breast Cancer ◽  
Retrospective Studies ◽  
Tumor Biology ◽  
Surgical Margin ◽  
Breast Conserving Therapy ◽  
Surgical Margins ◽  
Margin Assessment ◽  
Margin Width ◽  
Definition Of ◽  
Made In

There has been, and continues to be, significant controversy over the definition of an “optimal” surgical margin in breast-conserving therapy (BCT). The historic basis of this controversy stems from the original trials documenting the safety of BCT and many conflicting retrospective studies that have sought to define the association between surgical margin width and outcomes over the last 20 years. It is important to understand that margin assessment is an inexact science, and current laboratory approaches to surgical-margin assessment represent only a sampling of the surgical margin. Currently available evidence suggests that decisions regarding surgical margins in BCT should be made in the context of what is known about the biology of breast cancer, as well the interactions of tumor biology, adjuvant treatment for breast cancer, and outcomes. Achieving consensus on management of surgical margins in BCT should be a clinical priority as it offers the opportunity to reduce the burden of breast cancer treatment on patients without compromising cancer-related outcomes.

scholarly journals Clinical efficacy of intraoperative ultrasound for margin assessment in breast conserving surgery

2020 ◽  
Author(s):  
Jeeyeon Lee ◽  
Ho Yong Park ◽  
Wan Wook Kim ◽  
Chan Sub Park ◽  
Yungeun Ji ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Resection Margin ◽  
Frozen Section ◽  
Intraoperative Ultrasound ◽  
Surgical Margin ◽  
Breast Conserving Surgery ◽  
Margin Assessment ◽  
Clinicopathologic Characteristics ◽  
Tumor Margin ◽  
The Mean

Abstract Background: Surgical margin negativity is highly related to local recurrence of breast cancer. The authors performed this study to evaluate if specimen mammography or ultrasonography can replace the frozen section procedure for surgical margins. Methods: One-hundred fifty five patients with breast cancer were included in this study. After the surgery, the frozen biopsies were assessed in more than three different directions, and all specimens were analyzed with mammography and ultrasonography. The clinicopathologic characteristics of the patients were assessed, and closest tumor margin–resection margin distance (TM–RM distance) to the tumor was compared among specimen mammography, ultrasonography, and pathology. Results: On comparing initial cases of positive and negative margins, the mean closest TM–RM distance in specimen ultrasonography and final pathologic reports was statistically different between both groups (DCIS: p < 0.001, p = 0.006; IDC: p = 0.042, p = 0.022). Conclusion: When the closest TM–RM distance is less than 1.8 mm in specimen ultrasonography, the frozen section cannot be waived because of high risk of margin positivity. However, if the closest TM–RM distance is >4 mm in specimen ultrasonography, the frozen section can be omitted carefully because of the very low risk of margin positivity.

scholarly journals Value of intraoperative frozen section analysis in re-excision margin evaluation in breast-conserving surgery for cancer: a single institution experience

2020 ◽  
Author(s):  
Jian Guo Shen ◽  
Lin Bo Wang ◽  
Zi Nong Jiang ◽  
Xiao Ming Yuan ◽  
Wen He Zhao ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Ductal Carcinoma ◽  
Frozen Section ◽  
Positive Margin ◽  
Breast Conserving Surgery ◽  
Histological Type ◽  
Intraoperative Frozen Section ◽  
Excision Margin ◽  
Frozen Section Analysis ◽  
Section Analysis

Abstract Background. Previous studies have demonstrated that in women with breast cancer treated with breast-conserving surgery (BCS), intraoperative frozen section analysis of lumpectomy margins results in a decrease in reoperation rates for margin control. However, the value of intraoperative frozen margin evaluation (FME) in re-excision margin analysis is not fully understood. We analyzed our breast cancer database to identify the value of intraoperative frozen section examination of specimens additionally resected prior to BCS. Methods. We conducted a retrospective review of patients who underwent attempted BCS for breast cancer with routine intraoperative FME at our institution between January 1998 and May 2016. The number of FMEs was analyzed. We additionally analyzed factors associated with positive re-excised margins to identify correlations with patient characteristics. Results. Of the 760 patients who underwent attempted BCS with routinely conducted intraoperative FME, frozen sections were obtained from the initial margin only in 82.5% (n=627), the initial margin as well as a one-time re-excision analysis in 15.8% (n=120), or the initial margin and two or more re-excision analyses in 1.7% (n-13). Based on the results of FME, 727 (95.6%) of the patients underwent BCS, while the remaining 33 (4.4%) converted to mastectomy. Among the patients who underwent BCS, 112 (15.4%) had an initial positive margin on a FME, underwent one-time margin re-excision and achieved a margin-free status, while 1.6% underwent a second margin resection due to a positive result on the first re-excised margin. In total, 72.7% of the conversions to mastectomy were due to a positive initial margin. Univariate and multivariate analyses showed that patients with the ductal carcinoma in situ (DCIS) histological type were more likely to have repeatedly positive re-excised margins during BCS. Conclusion. While routine intraoperative FME of re-excised margins provided only limited value in patients who underwent attempted BCS, this method may be beneficial in the subgroup of patients with the DCIS histological type.

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