Margin re-excision rates following wide local excision with surgeon-operated intraoperative ultrasound.
Association of Breast Surgery ePoster Library. Worsfold J. 05/13/19; 257201; P159
Mr. James Worsfold
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P159
Topic: Surgical techniques
Introduction: Positive resection margins following wide local excision for breast cancer is a significant issue often requiring additional surgery and resources. NICE guidelines recommends consideration of re-excision if margin is less than 2mm. Recent meta-analysis (Koning et al, 2018) quotes 4-23% positive margin rate (PMR) for breast cancer requiring re-excision.Our aim was to evaluate the usefulness of surgeon operated intraoperative ultrasound in the reduction of PMRs. Methods All breast cancer patients at Southend University Hospital undergoing surgeon operated intraoperative ultrasound localisation from July to October 2018 were identified. Patients who had additional methods of localisation such as guide wires and skin markers were excluded. Demographic and histopathological data including size, grade and type of tumour and closest resection margin were analysed. Results15 patients with mean age of 60.7(45-75) were included in the study. All tumours were T1 (7mm -20mm) with ductal carcinoma being the most common type (65%). Resection margins were less than 5 mm in six patients (40%) and 5-10mm in eight patients (53.3%) with one patient having positive margin requiring additional intervention (PMR of 6.7%). ConclusionPMR from a previous study in our institution using standard method of localisation with guide wire or skin marker was 19% (n=70). However, the current study shows considerable reduction in re-excision rate (6.7%) highlighting real-time intraoperative ultrasound as a promising method. Further studies are planned to substantiate our findings and identify potential quality improvements by saving resources, radiology time and reducing patient discomfort.Audit registered and approved within trust.
Topic: Surgical techniques
Introduction: Positive resection margins following wide local excision for breast cancer is a significant issue often requiring additional surgery and resources. NICE guidelines recommends consideration of re-excision if margin is less than 2mm. Recent meta-analysis (Koning et al, 2018) quotes 4-23% positive margin rate (PMR) for breast cancer requiring re-excision.Our aim was to evaluate the usefulness of surgeon operated intraoperative ultrasound in the reduction of PMRs. Methods All breast cancer patients at Southend University Hospital undergoing surgeon operated intraoperative ultrasound localisation from July to October 2018 were identified. Patients who had additional methods of localisation such as guide wires and skin markers were excluded. Demographic and histopathological data including size, grade and type of tumour and closest resection margin were analysed. Results15 patients with mean age of 60.7(45-75) were included in the study. All tumours were T1 (7mm -20mm) with ductal carcinoma being the most common type (65%). Resection margins were less than 5 mm in six patients (40%) and 5-10mm in eight patients (53.3%) with one patient having positive margin requiring additional intervention (PMR of 6.7%). ConclusionPMR from a previous study in our institution using standard method of localisation with guide wire or skin marker was 19% (n=70). However, the current study shows considerable reduction in re-excision rate (6.7%) highlighting real-time intraoperative ultrasound as a promising method. Further studies are planned to substantiate our findings and identify potential quality improvements by saving resources, radiology time and reducing patient discomfort.Audit registered and approved within trust.
P159
Topic: Surgical techniques
Introduction: Positive resection margins following wide local excision for breast cancer is a significant issue often requiring additional surgery and resources. NICE guidelines recommends consideration of re-excision if margin is less than 2mm. Recent meta-analysis (Koning et al, 2018) quotes 4-23% positive margin rate (PMR) for breast cancer requiring re-excision.Our aim was to evaluate the usefulness of surgeon operated intraoperative ultrasound in the reduction of PMRs. Methods All breast cancer patients at Southend University Hospital undergoing surgeon operated intraoperative ultrasound localisation from July to October 2018 were identified. Patients who had additional methods of localisation such as guide wires and skin markers were excluded. Demographic and histopathological data including size, grade and type of tumour and closest resection margin were analysed. Results15 patients with mean age of 60.7(45-75) were included in the study. All tumours were T1 (7mm -20mm) with ductal carcinoma being the most common type (65%). Resection margins were less than 5 mm in six patients (40%) and 5-10mm in eight patients (53.3%) with one patient having positive margin requiring additional intervention (PMR of 6.7%). ConclusionPMR from a previous study in our institution using standard method of localisation with guide wire or skin marker was 19% (n=70). However, the current study shows considerable reduction in re-excision rate (6.7%) highlighting real-time intraoperative ultrasound as a promising method. Further studies are planned to substantiate our findings and identify potential quality improvements by saving resources, radiology time and reducing patient discomfort.Audit registered and approved within trust.
Topic: Surgical techniques
Introduction: Positive resection margins following wide local excision for breast cancer is a significant issue often requiring additional surgery and resources. NICE guidelines recommends consideration of re-excision if margin is less than 2mm. Recent meta-analysis (Koning et al, 2018) quotes 4-23% positive margin rate (PMR) for breast cancer requiring re-excision.Our aim was to evaluate the usefulness of surgeon operated intraoperative ultrasound in the reduction of PMRs. Methods All breast cancer patients at Southend University Hospital undergoing surgeon operated intraoperative ultrasound localisation from July to October 2018 were identified. Patients who had additional methods of localisation such as guide wires and skin markers were excluded. Demographic and histopathological data including size, grade and type of tumour and closest resection margin were analysed. Results15 patients with mean age of 60.7(45-75) were included in the study. All tumours were T1 (7mm -20mm) with ductal carcinoma being the most common type (65%). Resection margins were less than 5 mm in six patients (40%) and 5-10mm in eight patients (53.3%) with one patient having positive margin requiring additional intervention (PMR of 6.7%). ConclusionPMR from a previous study in our institution using standard method of localisation with guide wire or skin marker was 19% (n=70). However, the current study shows considerable reduction in re-excision rate (6.7%) highlighting real-time intraoperative ultrasound as a promising method. Further studies are planned to substantiate our findings and identify potential quality improvements by saving resources, radiology time and reducing patient discomfort.Audit registered and approved within trust.
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