Intra-operative specimen sonography: a valuable tool to identify tumor free margins during breast-conserving therapy

Abstract #4146 Background: Today, breast conserving therapy (BCT) represents the standard of care for the majority of patients with breast cancer. One significant technical difficulty remaining for the surgeon is the intraoperative estimation of tumor size in the attempt to achieve clear margins. We hypothesized that the use of intraoperative ultrasound evaluation of specimen would increase the rate of microscopically clear margins during lumpectomy. Methods: All patients who underwent lumpectomy for breast cancer at our hospital during 2007 were eligible. The study was non-randomized with retrospective data acquisition. In cases with positive ultrasound margins, the surgeon was guided to achieve disease- free margins. All cases with intraoperative specimen ultrasound were compared to cases without specimen sonography. We evaluated the technique of intraoperative sonography, the rate of tumor free margins, and the rate of re-excisions. Results: Of the 252 patients, 78 patients (31%) were evaluated with intraoperative specimen sonography. Operation times did not show significant differences in both groups. In the group with intraoperative specimen sonography the rate of microscopically free margins was 96%, compared to 81% in the control group. Intraoperative specimen sonography proved to be a useful adjunct in this series of patients because it significantly reduced the rate of re-excisions. Conclusion: Intraoperative specimen sonography proved to be a reliable and helpful tool for detection of tumor free margins in lumpectomy for breast cancer. It significantly reduces the rate of re-excions during breast conserving therapy. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4146.