Ivanovic Nebojsa S, Zdravkovic Darko D, Skuric Zlatko, Kostic Jelena, Colakovic Natasa, Stojiljkovic Miodrag, Opric Svetlana, Stefanovic Radovic Magdalena, Soldatovic Ivan, Sredic Biljana, Granic Miroslav
Department of Surgical Oncology, UMC Bezanijska Kosa, Autoput bb, Belgrade, 11000, Serbia.
Medical Faculty of Belgrade University, Dr Subotica 8, Belgrade, 11000, Serbia.
World J Surg Oncol. 2015 Apr 18;13:153. doi: 10.1186/s12957-015-0568-8.
We present a surgical technique and the preliminary results of breast cancer excision after insertion of a specially constructed marking needle into the tumor, controlled by intraoperative ultrasound. Resection margins were projected in six directions by ultrasound measurements, determined in relation to the needle, and resection was done in accordance with those measurements. The main objective was to obtain resection margins similar (equal) to those projected by intraoperative ultrasound (10 mm).
Detailed description of the technique is given. Thirty-two female patients undergoing breast-conserving surgery, up to 30 mm in diameter, for palpable and non-palpable invasive breast cancer, were operated on using this technique. Its feasibility was tested by analyzing the success (rate) of needle placement in the tumor, the measurements executed, and the performance of the excision.
All stages of the technique were successfully performed to completion on all 32 patients. The procedure of needle placement and ultrasound measurement of distances took 11 min on average (between 6 and 20 min). The average distance of the tumor margin from the resection margin was 12.9 mm (2 to 30 mm, 95% confidence interval [11.9, 14.06]). There was one patient with a positive resection margin (3%).
The technique of excising palpable and non-palpable breast cancer by intraoperative ultrasound and an especially constructed marking needle is feasible and comfortable to perform. Preliminary results imply that resection volume can be rationalized, with the same or better oncological safety.
我们介绍一种手术技术及在肿瘤内插入特制标记针后行乳腺癌切除的初步结果，该操作由术中超声控制。通过超声测量在六个方向上确定相对于针的切除边缘，并根据这些测量结果进行切除。主要目标是获得与术中超声预测的切除边缘相似（相等）（10毫米）的切除边缘。
给出了该技术的详细描述。32例直径达30毫米、可触及或不可触及的浸润性乳腺癌女性患者接受保乳手术，采用该技术进行操作。通过分析针在肿瘤内放置的成功率、所进行的测量以及切除的效果来测试其可行性。
该技术的所有阶段在所有32例患者中均成功完成。针放置和超声测量距离的过程平均耗时11分钟（6至20分钟）。肿瘤边缘与切除边缘的平均距离为12.9毫米（2至30毫米，95%置信区间[11.9, 14.06]）。有1例患者切除边缘阳性（3%）。
通过术中超声和特制标记针切除可触及和不可触及乳腺癌的技术可行且操作简便。初步结果表明，切除范围可合理确定，肿瘤学安全性相同或更佳。
