Intraoperative breast specimen assessment in breast conserving surgery: comparison between standard mammography imaging and a remote radiological system

Giovanna Mariscotti, Manuela Durando, Luca Jacopo Pavan, Alberto Tagliafico, Pier Paolo Campanino, Isabella Castellano, Riccardo Bussone, Ada Ala, Corrado De Sanctis, Laura Bergamasco, Paolo Fonio, Nehmat Houssami

Research output: Contribution to journalArticle

Abstract

Objective: To compare standard specimen mammography (SSM) with remote intraoperative specimen mammography (ISM) assessment in breast conserving-surgery (BCS) based on operative times, intraoperative additional excision (IAE) and re-intervention rates. Methods and materials: We retrospectively compared 129 consecutive patients (136 lesions) who had BCS with SSM at our centre between 11/2011 and 02/2013 with 138 consecutive patients (144 lesions) who underwent BCS with ISM between 08/2014 and 02/2015. SSM or ISM were performed to confirm the target lesions within the excised specimen and margin adequacy. The utility of SMM and ISM was evaluated considering pathology as gold-standard, using chi(2) or Fisher's exact tests for comparison of categorical variables, and non-parametric Mann-Whitney test for continuous variables. Results: The two groups did not statistically differ for age (p = 0.20), lesion size (p = 0.29) and morphology (p = 0.82) or tumor histology type (p = 0.65). Intraoperative time was significantly longer (p <0.00001) for SSM (132 +/- 43 min) than for ISM (90 +/- 42 min). The proportions requiring IAE did not significantly differ between SSM group (39/ 136 lesions (40%)) and ISM group (52/144 lesions (57%)) (p = 0.19), overall and in stratified analysis by mammographic features. Re-intervention rates were not statistically different between the two groups [SSM:19/136 (14%), ISM:13/144 (9%); p = 0.27]. Conclusion: The introduction of ISM in BCS significantly reduced surgical time but did not change IAE and re-intervention rates, highlighting facilitated communication between surgeons and radiologists. Advances in knowledge: Compared to standard mammography imaging, the use of ISM significantly reduced surgical time.
Original languageEnglish
JournalBritish Journal of Radiology
Volume93
Issue number1109
DOIs
Publication statusPublished - 2020

Keywords

  • ONCOLOGIA
  • ARTICOLO
  • RIS

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    Mariscotti, G., Durando, M., Pavan, L. J., Tagliafico, A., Campanino, P. P., Castellano, I., Bussone, R., Ala, A., De Sanctis, C., Bergamasco, L., Fonio, P., & Houssami, N. (2020). Intraoperative breast specimen assessment in breast conserving surgery: comparison between standard mammography imaging and a remote radiological system. British Journal of Radiology, 93(1109). https://doi.org/10.1259/bjr.20190785