Department of Surgery, University of Virginia, Charlottesville, Virginia 22908, USA.
World J Surg Oncol. 2010 Jan 18;8:4. doi: 10.1186/1477-7819-8-4.
Lumpectomy re-excision to obtain negative margins is common. We compare the effect of two specimen orientation approaches on lumpectomy re-excision rates.
All women undergoing lumpectomy for breast cancer by a single surgeon between 03/2007 - 02/2009 were included. Lumpectomies underwent standard inking (SI) after surgery by a pathologist from 03/2007-02/2008 while intraoperative inking (II) with direct surgeon input was done from 03/2008-02/2009. Rates of margin positivity and re-excision were compared between these methods.
65 patients were evaluated, reflecting SI in 39 and II in 26 cases. Margin positivity rates of 46% [SI] vs. 23% [II] (p = 0.06) and re-excision rates of 38% [SI] vs. 19% [II] were observed. Residual disease at re-excision was found in 27% [SI] vs. 67% [II] of cases.
Intraoperative inking in this practice offered a simple way to reduce re-excision rates after lumpectomy and affect an improvement in quality of patient care.
为获得阴性切缘而再次切除肿瘤（保乳手术后切缘阳性的补救性切除）是常见的。我们比较了两种标本定位方法对保乳手术后再次切除率的影响。
所有在 2007 年 3 月至 2009 年 2 月间由同一位外科医生进行保乳手术的女性均纳入本研究。2007 年 3 月至 2008 年 2 月间，所有保乳手术均由病理医生进行标准标记（SI），而在 2008 年 3 月至 2009 年 2 月间，术中标记（II）则由外科医生直接进行。比较这两种方法的切缘阳性率和再次切除率。
共评估了 65 例患者，其中 SI 组 39 例，II 组 26 例。SI 组的切缘阳性率为 46%，II 组为 23%（p = 0.06），SI 组的再次切除率为 38%，II 组为 19%。在再次切除时发现残留疾病的患者分别占 SI 组的 27%和 II 组的 67%。
在本研究中，术中标记是一种简单的方法，可以降低保乳手术后的再次切除率，并提高患者的护理质量。
