Intra-operative specimen radiographs help minimize necessary tissue excision.

2004 DEC 2 - (NewsRx.com & NewsRx.net) -- Intra-operative specimen radiographs help surgeons determine adequacy of excision margins while minimizing the amount tissue removed during breast-conserving surgery.

"The ultimate goal of breast-conserving surgery (BCS) is to achieve survival and local control rates similar to those for mastectomy white providing improved cosmetic and functional results. The volume of breast tissue removed is the most significant determinant of the final cosmetic outcome of BCS. We hypothesized that intra-operative specimen radiograph (IOSR) during BCS may guide the surgeon to achieve clear radiographic and histological margins with minimum normal breast tissue excision, thus preserving cosmetic appearance," wrote A.R. Carmichael and colleagues, Russells Hall Hospital, Dudley, England.

The team "[evaluated] the effect of introducing the policy of IOSR on the weight of specimens of wide local excision of palpable invasive breast cancer. All consecutive patients who underwent therapeutic wide local excision for palpable invasive breast cancer from January 1, 2002, to March 31, 2003, were included in this study. A policy of IOSR was introduced in October 2002, thus all BCS done after October 1, 2002, underwent IOSR."

Carmichael and associates reported, "The mean (S.D.) specimen weight for the no intra-operative specimen radiograph (NIOSR) group was 74 grams compared to 46 g in the IOSR group, (p=0.0241, unpaired t-test with Welch's correction) and the mean tumor size for the NIOSR was 23(13) mm and for IOSR was 21(8) mm (p=ns, unpaired t-test with Welch's correction).

"A histologically ...