Evaluation of Intra-Operative Ultrasound in Assessing Clear Margin in Breast Conservative Surgery

Abstract Background While arm lymphedema following breast cancer treatment is a common complication; breast lymphedema following treatment is not uncommon. Several risk factors were found to contribute to breast lymphedema, Aim: We aimed to provide a systematic review to help avoiding or management of breast lymphoedema Method The search term 'breast lymphedema' was combined with 'breast conservative surgery' and was used to conduct literature research in PubMed and Medline. The term lymphedema was combined with breast, conservative and surgery to search Embase database. All papers published in English were included with no exclusion date limits Results A total of 2155 female patients were included in this review; age ranged from 26 to 90. Mean BMI was 28.4, most of the studies included patients who underwent conservative breast surgery. Incidence of breast lymphedema ranged from 24.8% to 90.4%. Several risk factors were linked to breast lymphedema after conservative breast surgery, such as body mass index (BMI), breast size, tumour size, tumour site, type of surgery and adjuvant therapy. Treatment options focused on decongestive lymphatic therapy, including Manual lymphatic drainage (MLD), self-massaging, compression bras or Kinesio taping. Conclusions Breast lymphedema is a relatively common complication, yet there is no clear consensus on the definition or treatment options.

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Paravertebral block in regional anesthesia with propofol sedation reduces locoregional recurrence in patients with breast cancer receiving breast conservative surgery compared with volatile inhalational without propofol in general anesthesia

Biomedicine & Pharmacotherapy ◽

10.1016/j.biopha.2021.111991 ◽

2021 ◽

Vol 142 ◽

pp. 111991

Author(s):

Jiaqiang Zhang ◽

Chia-Lun Chang ◽

Chang-Yun Lu ◽

Ho-Min Chen ◽

Szu-Yuan Wu

Keyword(s):

Breast Cancer ◽

General Anesthesia ◽

Regional Anesthesia ◽

Locoregional Recurrence ◽

Conservative Surgery ◽

Paravertebral Block ◽

Propofol Sedation ◽

Breast Conservative Surgery

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Ultrasound-Guided Breast-Conservative Surgery Decreases the Rate of Reoperations for Palpable Breast Cancer

The American Surgeon ◽

10.1177/000313481808400663 ◽

2018 ◽

Vol 84 (6) ◽

pp. 1043-1048

Author(s):

Salvatore Vieni ◽

Giuseppa Graceffa ◽

Roberta Priola ◽

Martina Fricano ◽

Stefania Latteri ◽

...

Keyword(s):

Breast Cancer ◽

Histological Examination ◽

Standard Technique ◽

Positive Margin ◽

Conservative Surgery ◽

Ultrasound Guided ◽

Surgical Specimen ◽

Positive Margins ◽

Breast Conservative Surgery ◽

Palpable Breast

The purpose of this study is to verify whether the performance of ultrasound-guided quadrantectomy (USGQ) versus palpation-guided quadrantectomy (PGQ) can reduce the incidence of positive margins and if it can change the attitude of the surgeon. A retrospective study was conducted on 842 patients underwent quadrantectomy for breast cancer, 332 of them underwent USGQ, whereas 550 underwent PGQ. The histological type of the tumors and the margin status obtained with the histological examination were compared. The histological examination of the surgical specimen showed involvement of the margins in 24/842 patients (2.85%), 22 (2.61%) of them belonged to the PGQ group, and two to the USGQ group (P = 0.0011). The highest rate of microscopically positive margins was, statistically significant, for carcinoma in situ, when compared with patients with invasive carcinoma (0.0001). USGQ technique showed several advantages compared with PGQ. In fact, the former notes a lower positive margin rate and, consequently, a lower rate of reintervention. In addition, it may change the surgeon's attitude by causing him to remove another slice of margin to ensure more histological negativity. It should be the gold standard technique for breast-conservative surgery of palpable tumors.

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