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Intraoperative Ultrasound Is Associated With Clear Lumpectomy Margins for Palpable Infiltrating Ductal Breast Cancer

Moore, Marcia M. MD*; Whitney, Lawrence A. BA; Cerilli, Lisa MD; Imbrie, John Z. PhD§; Bunch, Michael MBA; Simpson, Virginia B. RN; Hanks, and John B. MD

SCIENTIFIC PAPERS OF THE SOUTHERN SURGICAL ASSOCIATION
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Objective To evaluate the efficacy of intraoperative ultrasound in obtaining adequate surgical margins in women undergoing lumpectomy for palpable breast cancer.

Summary Background Data Adequacy of surgical margins is a subject of debate in the literature for women undergoing breast-conserving therapy. The emerging technology of intraoperative ultrasound-guided surgery lends itself well to a prospective study evaluating surgical accuracy and margin status after lumpectomy.

Methods Two groups of women undergoing lumpectomy for palpable breast cancer were studied, one group using intraoperative ultrasound (n = 27) and the other without (n = 24). Pathologic specimens were evaluated for size, margins, and accuracy, and patients were questioned about satisfaction with cosmetic results.

Results Surgical accuracy was improved with intraoperative ultrasound-guided surgery. Margin status was improved, patient satisfaction was equivalent, and cost was not affected using ultrasound technology. Intraoperative ultrasound appears especially efficacious for women whose preoperative mammogram shows dense parenchyma surrounding the lesion.

Conclusions The use of ultrasound-guided surgery optimizes the surgeon’s ability to obtain satisfactory margins for breast-conserving techniques in patients with breast cancer. Patient satisfaction is excellent and a cost savings is most likely realized.

From the *Martha Jefferson Physician Hospital Organization, Charlottesville, Virginia, the †Department of Surgery, ‡Department of Pathology, §Department of Mathematics, and ∥Department of Finance, University of Virginia Health Sciences Center, Charlottesville, Virginia

Presented at the 112th Meeting of the Southern Surgical Association December 4-6, Palm Beach, Florida.

Correspondence: Marcia Moore, MD, Martha Jefferson Physician Hospital Organization, 310 Old Ivy Way, Charlottesville, VA 22903.

E-mail: mmm7k@virginia.edu

Accepted for publication December 2000.

© 2001 Lippincott Williams & Wilkins, Inc.