Intraoperative ultrasound reduces the need for re-excision in breast-conserving surgery

BackgroundThe purpose of this study was to evaluate ultrasound-guided surgery for palpable breast cancer by comparing the standard palpation-guided surgery in terms of the extent of healthy breast tissue resection, the percentage of tumor-free margins, and cosmetic outcomes.MethodsThis was a prospective, observational cohort study conducted from January 2009 to July 2011. Breast cancer patients, diagnosed via biopsy, were operated in guidance with either ultrasound or palpation. Patient demographics, tumor features, intraoperative findings, pathologic and cosmetic results, intraoperative-measured ultrasound margins, and pathology margins were compared.ResultsUltrasound (US)-guided lumpectomy was performed on 84 women and palpation-guided lumpectomy on 80 women. Patient demographics and tumor characteristics showed no differences. The rate of re-excision was 17 % for the palpation-guided surgery group, and 6 % for the US-guided group (p = 0.03). There was good correlation between the closest margins recorded by US and pathology margins (r = 0.76, p = 0.01). Volume of resection was significantly larger in the palpation-guided group despite the similar size of tumors (p = 0.048). Cosmetic outcome of surgery was equivalent between groups.ConclusionsIntraoperative ultrasound guidance for excision of palpable breast cancers is feasible and gives results in terms of pathologic margins that are comparable with those achieved by standard palpation-guided excisions.

• Publication year

  2015

• Venue

  World Journal of Surgical Oncology

• Publication date

  2015-11-24

• Fields of study

  Medicine

• Identifiers
  DOI 10.1186/s12957-015-0731-2PMID 26596699PMCID 4657358
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Long-term objective esthetic outcome after breast-conserving therapy

  2015cited by this paper
• Intraoperative ultrasound guidance for palpable breast cancer excision (COBALT trial): a multicentre, randomised controlled trial.

  2013cited by this paper
• Intra-operative ultrasound versus wire-guided localization in the surgical management of non-palpable breast cancers: systematic review and meta-analysis

  2013cited by this paper
• Intraoperative ultrasound guidance for excision of non-palpable invasive breast cancer: a hospital-based series and an overview of the literature

  2012cited by this paper
• Recommendations for the aesthetic evaluation of breast cancer conservative treatment

  2012cited by this paper
• Positive or close margins in breast conserving surgery: is re-excision always necessary?

  2012cited by this paper
• A comparison of three methods for nonpalpable breast cancer excision.

  2011cited by this paper
• Resection Margins in Ultrasound-Guided Breast-Conserving Surgery

  2011influential reference
• Optimising surgical accuracy in palpable breast cancer with intra-operative breast ultrasound--feasibility and surgeons' learning curve.

  2011cited by this paper
• Excessive Resections in Breast‐Conserving Surgery: A Retrospective Multicentre Study

  2011cited by this paper
• Ultrasound-Guided Lumpectomy for Palpable Breast Cancers

  2011cited by this paper
• Autofluorescence and diffuse reflectance spectroscopy and spectral imaging for breast surgical margin analysis

  2010cited by this paper
• The Effects of Additional Tumor Cavity Sampling at the Time of Breast-Conserving Surgery on Final Margin Status, Volume of Resection, and Pathologist Workload

  2009cited by this paper
• Intraoperative Ultrasound Versus Mammographic Needle Localization for Ductal Carcinoma In Situ

  2009cited by this paper
• A prospective, randomized, controlled, multicenter study of a real-time, intraoperative probe for positive margin detection in breast-conserving surgery.

  2008cited by this paper
• Intraoperative ultrasound is an effective and preferable technique to localize non-palpable breast tumors.

  2008cited by this paper
• Intraoperative Ultrasound Localization of Nonpalpable Breast Cancers

  2007cited by this paper
• Intra-operative Sonography: A Valuable Aid During Breast-Conserving Surgery for Occult Breast Cancer

  2007cited by this paper
• Sonographic hematoma-guided vs wire-localized lumpectomy for breast cancer: a comparison of margins and volume of resection.

  2007cited by this paper
• Radiography of the surgical specimen in early stage breast lesions: diagnostic reliability in the analysis of the resection margins

  2007cited by this paper
• Hematoma-Directed Ultrasound-Guided (HUG) Breast Lumpectomy

  2006cited by this paper
• Cosmesis and satisfaction after breast‐conserving surgery correlates with the percentage of breast volume excised

  2003cited by this paper
• The value of a positive margin for invasive carcinoma in breast-conservative treatment in relation to local recurrence is limited to young women only.

  2003cited by this paper
• Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer.

  2002cited by this paper
• Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer.

  2002cited by this paper
• Surgical margins in patients with early-stage breast cancer treated with breast conservation therapy.

  2002cited by this paper
• Ultrasound-guided lumpectomy of nonpalpable breast cancer versus wire-guided resection: A randomized clinical trial

  2002cited by this paper
• Intraoperative Ultrasound Is Associated With Clear Lumpectomy Margins for Palpable Infiltrating Ductal Breast Cancer

  2001influential reference
• Intraoperative ultrasound-guided breast biopsy.

  2000cited by this paper
• Outcome at 8 years after breast-conserving surgery and radiation therapy for invasive breast cancer: influence of margin status and systemic therapy on local recurrence.

  2000cited by this paper
• Patients with early stage invasive cancer with close or positive margins treated with conservative surgery and radiation have an increased risk of breast recurrence that is delayed by adjuvant systemic therapy.

  1999cited by this paper
• Intraoperative Ultrasound Localization of Nonpalpable Breast Lesions

  1999cited by this paper
• Ultrasound‐guided lumpectomy of nonpalpable breast cancers: A feasibility study looking at the accuracy of obtained margins

  1999cited by this paper
• The false-negative mammogram.

  1998cited by this paper
• Detecting residual tumor after excisional biopsy of impalpable breast carcinoma: efficacy of comparing preoperative mammograms with radiographs of the biopsy specimen.

  1995cited by this paper
• Breast biopsy with needle localization: accuracy of specimen x-ray and management of missed lesions.

  1993cited by this paper
• Wire localized biopsy of breast lesions: a review of 425 cases found in screening or clinical mammography.

  1993cited by this paper

• Margin Matters: Advances in Intraoperative Margin Assessment for Breast-Conserving Surgery

  2025cites this paper
• Innovations in the localization techniques for non-palpable breast lesions: Make invisible visible

  2025cites this paper
• Image-Guided Breast Conserving Surgery

  2024cites this paper
• Three-dimensional surgical margin positioning technique versus palpation-guided method for breast-conserving surgery: Feasibility, advantages, and quality of life.

  2024cites this paper
• Comparison of ultrasound guided surgery and radio-guided occult lesions localization (ROLL) for nonpalpable breast cancer excision

  2023cites this paper
• Application of near-infrared fluorescence imaging in the accurate assessment of surgical margins during breast-conserving surgery

  2022cites this paper
• Intraoperative Ultrasound-Guided Excision of Non-Palpable and Palpable Breast Cancer: Systematic Review and Meta-Analysis.

  2022cites this paper
• A randomized study comparing intraoperative Ultrasound and Palpatory method in patients with breast cancer

  2022cites this paper
• The impact of intraoperative cavity shaving on re‐excision rates in breast‐conserving surgery

  2022cites this paper
• The Use of Intraoperative Ultrasound During Breast Conserving Surgery.

  2022cites this paper
• Systematic Review and Meta-Analysis of the Impact of Intra-Operative Ultrasound Guidance Breast-Conserving Surgery in Early Breast Cancer

  2021influential citation
• Intraoperative Sonografie zur Entfernung von nicht-palpablen und palpablen Mammakarzinomen: systematisches Review und Meta-Analyse

  2021cites this paper
• Impact of deformation on a supine-positioned image-guided breast surgery approach

  2021cites this paper
• Review of Variables Associated With Positive Surgical Margins Using Scout Reflector Localizations for Breast Conservation Therapy.

  2021cites this paper
• Review of methods of intraoperative margin assessment in breast conserving surgery

  2021cites this paper
• Evaluation of Intra-Operative Ultrasound in Assessing Clear Margin in Breast Conservative Surgery

  2020cites this paper
• Clinical efficacy of intraoperative ultrasound for margin assessment in breast‐conserving surgery

  2020cites this paper
• The Impact of Advanced Image-Guided Breast Surgery and Oncoplastic Techniques on Margin Positivity in Breast Conserving Surgery

  2020influential citation
• Small Breast Cancer (≤ 5 mm): Ultrasonographic Features and Clinical and Pathological Characteristics

  2019influential citation
• Digital Breast Tomosynthesis as a Tool in Confirming Negative Surgical Margins in Non-palpable Breast Lesions

  2019cites this paper
• Learning curves in intraoperative ultrasound guided surgery in breast cancer based on complete breast cancer excision and no need for second surgeries.

  2019cites this paper
• Use of Intraoperative Ultrasound During Breast Conservation Surgery (BCS) for Palpable Breast Cancer: an Extremely Effective Approach with Improved Oncological Outcome

  2019cites this paper
• Serial image changes in ultrasonography after the excision of benign breast lesions by mammotome® biopsy system

  2018cites this paper
• Value of intra-operative ultrasound in localization of palpable or non-palpable breast tumors during breast conserving surgery

  2018cites this paper
• Margins and Breast Cancer

  2018cites this paper
• Comparison of resection margins and cosmetic outcome following intraoperative ultrasound-guided excision versus conventional palpation-guided breast conservation surgery in breast cancer: A randomized controlled trial.

  2018cites this paper
• Ultrasound-guided preoperative localization of breast lesions: a good choice

  2018cites this paper
• Re-excision rate after sector resection for breast cancer: A 5-year retrospective cohort study

  2018cites this paper
• Obtaining adequate surgical margin status in breast-conservation therapy: intraoperative ultrasound-guided resection versus specimen mammography

  2018cites this paper
• Novel techniques for intraoperative assessment of margin involvement

  2018cites this paper
• Intraoperative digital specimen radiography in the treatment of nonpalpable breast lesions

  2017cites this paper
• Surgeon performed continuous intraoperative ultrasound guidance decreases re-excisions and mastectomy rates in breast cancer.

  2017cites this paper
• The value of ultrasound-guided surgery for breast cancer.

  2017cites this paper
• Intraoperative ultrasound guidance in breast-conserving surgery shows superiority in oncological outcome, long-term cosmetic and patient-reported outcomes: Final outcomes of a randomized controlled trial (COBALT).

  2017cites this paper
• Advances in Intraoperative Margin Assessment for Breast Cancer

  2016cites this paper
• A Novel Technique Using Intraoperative Fluoroscopy as a Tool to Achieve Negative Margins for Wire-Guided Partial Mastectomies

  2016cites this paper