Davis Karole M, Hsu Chiu-Hsieh, Bouton Marcia E, Wilhelmson Krista L, Komenaka Ian K
Department of Surgery, Maricopa Medical Center, Phoenix, Arizona, USA.
Am Surg. 2011 Jun;77(6):720-5.
Positive margins occur in 15 to 69 per cent of patients undergoing lumpectomy. The current study was performed to evaluate intraoperative ultrasound in patients undergoing lumpectomy for palpable breast cancer. A retrospective chart review was performed of patients with palpable cancer who underwent lumpectomy with intraoperative ultrasound from 2004 to 2009. Each patient was matched with two patients who underwent lumpectomy alone over the same time period. Matching criteria included tumor size, clinical stage, body mass index, age at diagnosis, and lymphovascular invasion or extensive intraductal component. Twenty-two consecutive patients who underwent lumpectomy with intraoperative ultrasound were matched with 44 patients who underwent lumpectomy without intraoperative ultrasound. In addition to matching criteria, the patients were similar with respect to ethnicity, insurance status, weight, predominant histology, estrogen receptor, progesterone receptor, and Her2 status. Patients who underwent lumpectomy with intraoperative ultrasound were significantly less likely to have an involved margin (41 vs 9%, P = 0.01) and less likely to require a re-excision (34 vs 9%, P = 0.04). The lumpectomy volumes in the intraoperative ultrasound group were smaller than the volumes in the lumpectomy alone group. Intraoperative ultrasound can decrease the rate of positive margins and re-excision lumpectomy in patients with palpable breast cancers.
在接受乳房肿瘤切除术的患者中，切缘阳性的发生率为15%至69%。本研究旨在评估术中超声在接受可触及乳腺癌乳房肿瘤切除术患者中的应用。对2004年至2009年期间接受术中超声引导下乳房肿瘤切除术的可触及癌症患者进行了回顾性病历审查。每位患者与同期仅接受乳房肿瘤切除术的两名患者进行匹配。匹配标准包括肿瘤大小、临床分期、体重指数、诊断时年龄以及淋巴管浸润或广泛导管内成分。连续22例接受术中超声引导下乳房肿瘤切除术的患者与44例未接受术中超声引导下乳房肿瘤切除术的患者进行匹配。除匹配标准外，患者在种族、保险状况、体重、主要组织学类型、雌激素受体、孕激素受体和Her2状态方面也相似。接受术中超声引导下乳房肿瘤切除术的患者切缘受累的可能性显著降低（41%对9%，P = 0.01），再次切除的可能性也降低（34%对9%，P = 0.04）。术中超声组的乳房肿瘤切除体积小于单纯乳房肿瘤切除组。术中超声可降低可触及乳腺癌患者切缘阳性率和再次切除乳房肿瘤切除术的发生率。
