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Intra-operative sonography: a valuable aid during breast-conserving surgery for occult breast cancer.

Abstract：

BACKGROUND:Breast cancer is increasingly detected during an early non-palpable stage. Together with pre-operative marking of the mass, intra-operative imaging provides invaluable clues. This study was designed to evaluate the usefulness of intra-operative sonography in the hands of the surgeon. METHODS:Between July 2001 and October 2006, 567 patients underwent treatment for operable breast cancer at the landeskrankenhaus (LHK) Feldkirch. Three hundred and sixty lesions were not palpable. Two hundred and ninety-nine patients with poorly definable or non-definable lesions well seen by ultrasound imaging underwent intra-operative sonography (group 1), while 61 patients with non-palpable lesions only seen on mammography (group 2) were subjected to pre-operative needle localization. The study was non-randomized with prospective data acquisition RESULTS:All lesions were identified by both sonography and pre-operative needle localization. In the ultrasound group (group 1) 81% of the lesions were successfully removed by primary intention without metachronous secondary surgery versus 62% in group 2 (p < 0.00228). Eighty-eight percent of the lesions in group 1 were eligible for breast-conserving surgery versus 75% in group 2. The mean clear margin in group 1 was substantially smaller (4.8 mm) than in group 2 (7.2 mm) (p < 0.0001). CONCLUSION:Intra-operative sonography proved to be a reliable and helpful tool in the hands of the surgeon, not only for tumor localization, but also for orientation during tumor excision. It simplifies organizational work and spares the patient the discomfort of pre-operative needle localization.

journal_name

Ann Surg Oncol

journal_title

Annals of surgical oncology

authors

Haid A,Knauer M,Dunzinger S,Jasarevic Z,Köberle-Wührer R,Schuster A,Toeppker M,Haid B,Wenzl E,Offner F

doi

10.1245/s10434-007-9490-9

subject

Has Abstract

pub_date

2007-11-01 00:00:00

pages

3090-101

issue

11

eissn

1068-9265

issn

1534-4681

journal_volume

14

pub_type

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