caa a22 4500 445338407 CHVBK 20180317142803.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1245/s10434-010-1280-0 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1280-0 Resection Margins in Ultrasound-Guided Breast-Conserving Surgery [Elektronische Daten] [Oded Olsha, David Shemesh, Moshe Carmon, Ohn Sibirsky, Ribhi Abu Dalo, Louis Rivkin, Itamar Ashkenazi] Background: Few published studies have shown the benefits of intraoperative ultrasound in avoiding inadequate margins in breast-conserving surgery. The aim of this study is to quantify intraoperative ultrasound margin size and assess its relationship to tumor size, multifocality, palpability, histology, and presence of intraductal component. Methods: Patients with breast cancer undergoing breast-conserving surgery in whom the operating surgeon visualized the tumor by ultrasound were included. Ultrasound margins measured intraoperatively were prospectively recorded and compared with pathology margins. Results: Forty-five patients with 48 tumors were included. Twenty five patients (56%) had palpable tumors. Pathologic mean tumor size was 1.9cm [95% confidence interval (CI) 1.6-2.2cm, range 0.5-4.8cm]. There was good correlation between closest margins recorded by ultrasound and pathology margins (r=0.4674, P<0.0008). Fourteen patients (31%) had margins re-excised intraoperatively, 12 of them in the direction of the closest pathological margin. Three patients (7%), all of whom had intraoperative re-excision, had a second operation for involved margins without residual cancer on pathological examination of the reoperative specimens. Ultrasound margins ≥0.5cm achieved adequate pathology margins of ≥0.2cm in 95% of margins. Overestimation of pathology margins by ultrasound measurement was significantly affected by multifocality (P=0.0473). Tumor size, palpability, invasive lobular histology, and presence of ductal carcinoma in situ (DCIS) did not cause significant overestimation of pathology margins by ultrasound. Conclusions: Intraoperative ultrasound may help maintain a low level of reoperation after breast-conserving surgery. Ultrasound margins <0.5cm should be re-excised intraoperatively. Reliability of ultrasound in predicting the closest pathology margins was diminished in patients with multifocal tumors. Society of Surgical Oncology, 2010 Olsha Oded Department of Surgery, Shaare Zedek Medical Center, Jerusalem, Israel aut Shemesh David Department of Surgery, Shaare Zedek Medical Center, Jerusalem, Israel aut Carmon Moshe Department of Surgery, Shaare Zedek Medical Center, Jerusalem, Israel aut Sibirsky Ohn Department of Surgery, Bikur Cholim Hospital, Jerusalem, Israel aut Abu Dalo Ribhi Department of Surgery, Shaare Zedek Medical Center, Jerusalem, Israel aut Rivkin Louis Department of Surgery, Shaare Zedek Medical Center, Jerusalem, Israel aut Ashkenazi Itamar Department of Surgery B, Hillel Yaffe Medical Center, Hadera, Israel aut Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 447-452 1068-9265 18:2<447 2011 18 10434 https://doi.org/10.1245/s10434-010-1280-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1280-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Olsha Oded Department of Surgery, Shaare Zedek Medical Center, Jerusalem, Israel aut NATIONALLICENCE 700 1- Shemesh David Department of Surgery, Shaare Zedek Medical Center, Jerusalem, Israel aut NATIONALLICENCE 700 1- Carmon Moshe Department of Surgery, Shaare Zedek Medical Center, Jerusalem, Israel aut NATIONALLICENCE 700 1- Sibirsky Ohn Department of Surgery, Bikur Cholim Hospital, Jerusalem, Israel aut NATIONALLICENCE 700 1- Abu Dalo Ribhi Department of Surgery, Shaare Zedek Medical Center, Jerusalem, Israel aut NATIONALLICENCE 700 1- Rivkin Louis Department of Surgery, Shaare Zedek Medical Center, Jerusalem, Israel aut NATIONALLICENCE 700 1- Ashkenazi Itamar Department of Surgery B, Hillel Yaffe Medical Center, Hadera, Israel aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 447-452 1068-9265 18:2<447 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer