Rivera Ronald J, Holmes Dennis R, Tafra Lorraine
Los Angeles Center for Women's Health and David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA.
Int J Surg Oncol. 2012;2012:868623. doi: 10.1155/2012/868623. Epub 2012 Dec 26.
Breast conserving surgery has been accepted as the optimal local therapy for women with early breast cancer, emphasizing the necessity to balance oncologic goals with patient satisfaction and cosmetic outcomes. In the move to enhance a surgeon's ability to achieve histologically clear margins intraoperatively at the initial surgery, the MarginProbe (Dune Medical Devices, Caesarea, Israel) has emerged as an effective tool to accomplish that task. Based on previously reported success using the device, we assessed cosmesis and tissue resection volumes among participants in a randomized-controlled trial comparing the standard of care lumpectomy performed with and without the MarginProbe. The use of the MarginProbe device resulted in a 57% reduction in reexcision rates compared to the control group with a small increase in tissue volume removed at the primary lumpectomy. When total tissue volumes removed were analyzed, the device and control groups were still very similar after normalization to bra cup size. We concluded that the MarginProbe is an effective device to assist surgeons in determining margin status intraoperatively while allowing for better patient cosmetic outcomes due to the smaller volumes of tissue resected and the reduction in patient referrals for second surgeries due to positive margins.
保乳手术已被公认为早期乳腺癌女性的最佳局部治疗方法,强调了平衡肿瘤学目标与患者满意度及美容效果的必要性。为了提高外科医生在初次手术中实现术中组织学切缘阴性的能力,MarginProbe(沙丘医疗设备公司,以色列凯撒利亚)已成为完成该任务的有效工具。基于此前报道的使用该设备的成功案例,我们在一项随机对照试验中评估了参与者的美容效果和组织切除量,该试验比较了使用和不使用MarginProbe进行保乳手术的标准治疗方法。与对照组相比,使用MarginProbe设备使再次切除率降低了57%,同时初次保乳手术切除的组织量略有增加。在分析切除的总组织量时,将设备组和对照组按胸罩罩杯尺寸进行标准化后,二者仍非常相似。我们得出结论,MarginProbe是一种有效的设备,可帮助外科医生在术中确定切缘状态,同时由于切除的组织量较小且因切缘阳性导致的患者二次手术转诊减少,从而实现更好的患者美容效果。