Blohmer Jens-Uwe, Tanko Julia, Kueper Janina, Groß Jessica, Völker Ragna, Machleidt Anna
Breast Center, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Department of Gynecology and Breast Center, Sankt-Gertrauden Hospital, Paretzer Str. 12, 10713, Berlin, Germany.
Arch Gynecol Obstet. 2016 Aug;294(2):361-7. doi: 10.1007/s00404-016-4011-3. Epub 2016 Jan 21.
A positive margin status after breast conserving surgery (BCS) is one of the strongest predictors for local recurrence of intraductal (DCIS) and invasive carcinoma. As much as 20-50 % of patients with BCS need to undergo a second operation to receive free margins. In this study we tested the clinical performance of MarginProbe© (Dune Medical Devices, Paoli, PA, USA), a device for the intraoperative evaluation of surgical margins.
A prospective clinical study was performed: The device was utilized in BCS of 150 patients treated at a single facility from November 2012 to June 2013. The re-excision rate was compared to the re-excision rate of a historical group of 172 patients treated with BCS at the same hospital without the application of the device. We analyzed whether the results of MarginProbe© are affected by the morphology, grading, size of the tumor, breast density, age, BMI or the use of marker-wires.
The application of MarginProbe© resulted in an overall decreased re-excision rate of 14.6 %. In the subgroup of DCIS the re-excision rate was reduced from 61.7 to 23.1 %. In the subgroup of invasive lobular carcinomas the re-excision rate decreased from 37.0 to 19.0 %. MarginProbe© results were not affected by grading, tumor size, breast density, age, BMI or marker-wire application.
MarginProbe© detects positive margins in invasive carcinoma, DCIS as well as in invasive lobular carcinoma. The device decreases the re-excision rate after BCS significantly. It does not interfere with any of the factors we examined.
保乳手术(BCS)后切缘阳性是导管原位癌(DCIS)和浸润性癌局部复发的最强预测因素之一。多达20%-50%的BCS患者需要接受二次手术以获得切缘阴性。在本研究中,我们测试了MarginProbe©(美国宾夕法尼亚州波利市沙丘医疗设备公司)的临床性能,这是一种用于术中评估手术切缘的设备。
进行了一项前瞻性临床研究:2012年11月至2013年6月期间,该设备在一家机构对150例行BCS的患者中使用。将再切除率与同一医院172例未使用该设备而行BCS的历史组患者的再切除率进行比较。我们分析了MarginProbe©的结果是否受肿瘤形态、分级、大小、乳腺密度、年龄、体重指数或标记线使用的影响。
使用MarginProbe©使总体再切除率降低了14.6%。在DCIS亚组中,再切除率从61.7%降至23.1%。在浸润性小叶癌亚组中,再切除率从37.0%降至19.0%。MarginProbe©的结果不受分级、肿瘤大小、乳腺密度、年龄、体重指数或标记线使用的影响。
MarginProbe©可检测浸润性癌、DCIS以及浸润性小叶癌的阳性切缘。该设备显著降低了BCS后的再切除率。它不干扰我们所研究的任何因素。