A device for real-time, intraoperative margin assessment in breast-conservation surgery.

BACKGROUND This trial was designed to study performance of a novel handheld probe (Dune Medical Devices, Caesarea, Israel) in intraoperative detection of positive margins and its potential benefit toward minimizing the positive margin rate. METHODS The probe was intraoperatively applied to 57 lumpectomy specimens. Surgeons were blinded to device output, and surgical decisions were not affected by probe data. Probe readings were compared with histological analysis per margin and per patient. RESULTS Nineteen of 22 (86%) pathology-positive patients were intraoperatively detected with device use. Per-margin sensitivity was .71, and specificity was .68, maintained within a range of positive margin definitions (0-.4 cm). CONCLUSIONS The device is an effective tool for intraoperative detection of positive margins with the potential for significant positive margin rate reduction.

[1]  G. Mann Less Is (Usually) More: When Is Amputation Appropriate for Treatment of Extremity Soft Tissue Sarcoma? , 2005, Annals of Surgical Oncology.

[2]  A. Jemal,et al.  Cancer Statistics, 2007 , 2007, CA: a cancer journal for clinicians.

[3]  Saveli Goldberg,et al.  Current Perceptions Regarding Surgical Margin Status After Breast-Conserving Therapy: Results of a Survey , 2005, Annals of surgery.

[4]  Pat Whitworth,et al.  Prospective randomized study comparing cryo-assisted and needle-wire localization of ultrasound-visible breast tumors. , 2006, American journal of surgery.

[5]  Umberto Veronesi,et al.  Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. , 2002, The New England journal of medicine.

[6]  S. Singletary Surgical margins in patients with early-stage breast cancer treated with breast conservation therapy. , 2002, American journal of surgery.

[7]  I. Bleiweiss,et al.  The Consequence of Multiple Re-Excisions to Obtain Clear Lumpectomy Margins in Breast Cancer Patients , 2005, Annals of Surgical Oncology.

[8]  Lawrence B. Marks,et al.  The NCCN. Invasive breast cancer: Clinical practice guidelines in oncology™ , 2007 .

[9]  R. Arriagada,et al.  Conservative treatment versus mastectomy in early breast cancer: patterns of failure with 15 years of follow-up data. Institut Gustave-Roussy Breast Cancer Group. , 1996, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[10]  B. E. F. Isher,et al.  Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. , 2002 .

[11]  P Okunieff,et al.  Ten-year results of a comparison of conservation with mastectomy in the treatment of stage I and II breast cancer. , 1995, The New England journal of medicine.