Abstract:
BACKGROUND:The presence of tumor cells at the margins of breast lumpectomy specimens is associated with an increased risk of ipsilateral tumor recurrence. Twenty to 30 % of patients undergoing breast-conserving surgery require second procedures to achieve negative margins. This study evaluated the adjunctive use of the MarginProbe device (Dune Medical Devices Ltd, Caesarea, Israel) in providing real-time intraoperative assessment of lumpectomy margins. METHODS:This multicenter randomized trial enrolled patients with nonpalpable breast malignancies. The study evaluated MarginProbe use in addition to standard intraoperative methods for margin assessment. After specimen removal and inspection, patients were randomized to device or control arms. In the device arm, MarginProbe was used to examine the main lumpectomy specimens and direct additional excision of positive margins. Intraoperative imaging was used in both arms; no intraoperative pathology assessment was permitted. RESULTS:In total, 596 patients were enrolled. False-negative rates were 24.8 and 66.1 % and false-positive rates were 53.6 and 16.6 % in the device and control arms, respectively. All positive margins on positive main specimens were resected in 62 % (101 of 163) of cases in the device arm, versus 22 % (33 of 147) in the control arm (p < 0.001). A total of 19.8 % (59 of 298) of patients in the device arm underwent a reexcision procedure compared with 25.8 % (77 of 298) in the control arm (6 % absolute, 23 % relative reduction). The difference in tissue volume removed was not significant. CONCLUSIONS:Adjunctive use of the MarginProbe device during breast-conserving surgery improved surgeons' ability to identify and resect positive lumpectomy margins in the absence of intraoperative pathology assessment, reducing the number of patients requiring reexcision. MarginProbe may aid performance of breast-conserving surgery by reducing the burden of reexcision procedures for patients and the health care system.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Schnabel F,Boolbol SK,Gittleman M,Karni T,Tafra L,Feldman S,Police A,Friedman NB,Karlan S,Holmes D,Willey SC,Carmon M,Fernandez K,Akbari S,Harness J,Guerra L,Frazier T,Lane K,Simmons RM,Estabrook A,Allweis Tdoi
10.1245/s10434-014-3602-0subject
Has Abstractpub_date
2014-05-01 00:00:00pages
1589-95issue
5eissn
1068-9265issn
1534-4681journal_volume
21pub_type
杂志文章,随机对照试验abstract:: ...
journal_title:Annals of surgical oncology
pub_type: 评论,杂志文章
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pub_type: 临床试验,杂志文章
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
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journal_title:Annals of surgical oncology
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更新日期:2012-03-01 00:00:00
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journal_title:Annals of surgical oncology
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更新日期:2018-05-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章
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journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
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更新日期:2014-07-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2007-02-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
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journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
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journal_title:Annals of surgical oncology
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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journal_title:Annals of surgical oncology
pub_type: 杂志文章,meta分析
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