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Intra-operative Sonography: A Valuable Aid During Breast-Conserving Surgery for Occult Breast Cancer

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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.

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Authors and Affiliations

  1. Department of General and Thoracic Surgery, Landeskrankenhaus Feldkirch, Teaching Hospital of Innsbruck University, Carinagasse 47-49, 6800, Feldkirch, Austria

    Anton Haid MD, Michael Knauer MD, Stephanie Dunzinger MD, Roswitha Köberle-Wührer MD, Bernhard Haid MD & Etienne Wenzl MD, FRCS

  2. Institute of Pathology, Landeskrankenhaus Feldkirch, Teaching Hospital of Innsbruck University, Carinagasse 47-49, 6800, Feldkirch, Austria

    Zerina Jasarevic MD & Felix Offner MD

  3. Central Radiology Unit, Landeskrankenhaus Feldkirch, Teaching Hospital of Innsbruck University, Carinagasse 47-49, 6800, Feldkirch, Austria

    Antonius Schuster MD & Michael Toeppker MD

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  1. Anton Haid MD
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Correspondence to Anton Haid MD.

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Haid, A., Knauer, M., Dunzinger, S. et al. Intra-operative Sonography: A Valuable Aid During Breast-Conserving Surgery for Occult Breast Cancer. Ann Surg Oncol 14, 3090–3101 (2007). https://doi.org/10.1245/s10434-007-9490-9

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  • DOI: https://doi.org/10.1245/s10434-007-9490-9

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