Localization of subclinical breast lesions with a metal marker (hookwire)
Surgical margins analysis
Abstract
Introduction: lesion resection with tumor free margins is the objective in breast cancer. If there is a tumor in the surgical margin the rates of recurrence will be higher.
Objectives: to evaluate the experience at the Centro de Diagnóstico Mamario (CENDIMA – Breast Diagnosis Center) of the Asociación Española Primera de Socorros Mutuos, in terms of conservative surgery of breast cancer guided by metal markers. The surgical margins width and the factors associated with the positive margins are studied.
Method: we analysed all cases of subclinical breast cancer treated with conservative surgery guided by metal markers from January 2007 through December 2009 (147 cases).
Results: margins were positive (in contact with the lesion or nearest margin width was up to 1mm) in 39 cases (26%) and negative (width was 22 mm or larger) in 108 cases (74%).
Average lesion size was greater the positive margin cases (15,6 mm compared to 11,4 mm).
An in-situ ductal component was more frequently observed among the positive margins population (82% compares to 42%), and microcalcifications were more frequent in mammographic images (51% compared to 14%). Re-excision due to insufficient margins was performed in 42 cases (29%) and residual tumors were found in 21 of these cases (50%).
Conclusion: the profile of the lesion that is more likely to evidence positive surgical margins after a conservative surgery guided by a metal marker is the following: lesion greater than 10 mm, with an in-situ component in its histology and microcalcification observed in the image.
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