Peña Ayón Alma Rita, Mainero Ratchelous Fernando Enrique, Vargas Solano Juan Manuel, Buenrostro Pineda Marco Antonio, Bernechea Miranda Abel, Burgos Portillo Iván, Aguilar Gallegos Uriban Israel, Balcázar Rodríguez Javier
Servicio de patología mamaria, diagnóstico y tratamiento, Hospital de Ginecología y Obstetricia núm. 4, Luis Castelazo Ayala, IMSS, delegación 3 Suroeste, México, DF.
Ginecol Obstet Mex. 2007 Oct;75(10):588-602.
Wide surgical margins are prognostic indicators to prevent recurrences after conservative surgery in breast cancer; type of surgery and histopathological analysis are key factors too.
To evaluate tumoral size and surgical margins of quadrantectomy specimens utilizing mammography and histopathology, and decide if mammography of quadrantectomy specimens are useful for close margins prediction.
Prospective, observational and descriptive study based on the findings of specimen projections of two mammography quadrantectomies, and histopathological data. Ten patients with breast cancer were evaluated from May to November 2006. Surgical margins of quadrantectomys were marked with radiopaque material.
Tumoral size was similar in mammography and histopathological analysis of quadrantectomys, however there was a tendency to report a larger size in mammography. With mammography only one case was reported as close superficial margin, the rest of patients has adequate margins (1 cm or higer). Five cases were close by histopathology (3 in the deep margin, one superior and one more in the superior and inferior margins), and five had adequate margins. Four additional surgical procedures where practiced (3 re-excisions and one mastectomy), in one of them additional surgery was unnecessary.
Mammography evaluation was useful to identify peripheral margins (superior, inferior medial and lateral) as well as tumoral size, but useless to identify close borders (deep and superficial areas). It is necessary to evaluate more cases to improve this technique and to establish a common language between specialists.
广泛的手术切缘是预防乳腺癌保乳手术后复发的预后指标；手术类型和组织病理学分析也是关键因素。
利用乳腺X线摄影和组织病理学评估象限切除术标本的肿瘤大小和手术切缘，并确定象限切除术标本的乳腺X线摄影是否有助于预测切缘情况。
基于两项乳腺象限切除术标本投影结果和组织病理学数据进行前瞻性、观察性和描述性研究。对2006年5月至11月的10例乳腺癌患者进行评估。象限切除术的手术切缘用不透射线材料标记。
象限切除术标本的乳腺X线摄影和组织病理学分析中肿瘤大小相似，但乳腺X线摄影倾向于报告更大的尺寸。仅通过乳腺X线摄影，有1例报告为浅切缘接近，其余患者切缘足够（1厘米或更高）。组织病理学显示5例切缘接近（3例为深切缘，1例为上切缘，1例为上、下切缘），5例切缘足够。另外进行了4次手术（3次再次切除和1次乳房切除术），其中1次额外手术不必要。
乳腺X线摄影评估有助于识别外周切缘（上、下、内侧和外侧）以及肿瘤大小，但对识别接近边界（深部和浅部区域）无用。有必要评估更多病例以改进该技术并在专家之间建立通用语言。
