UOSD Breast Unit ULSS9 Scaligera, Fracastoro Hospital, 1 Via Circonvallazione, 37047, San Bonifacio, VR, Italy.
Department of Diagnostic Imaging, Radiation Oncology and Haematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Radiol Med. 2021 Jun;126(6):768-773. doi: 10.1007/s11547-021-01337-9. Epub 2021 Feb 24.
We investigated the accuracy of digital breast tomosynthesis compared to full-field digital mammography for evaluating tumor-free resection margins in the intraoperative specimen during breast-conserving surgery, reducing re-excision rates.
In total, 170 patients, with proven breast cancer and eligible for breast-conserving surgery, were enrolled. Intraoperative specimens underwent digital mammography and digital breast tomosynthesis. Two breast radiologists, with ten years of experience in breast imaging, in batch mode, evaluated tumor-free resection margins and the distance between the margins and lesion. Histopathological findings were considered the standard of reference.
We used the correlation analysis to evaluate the agreement between measures of tumor-free resection margins obtained with digital mammography and the true value (histopathological findings), and between digital breast tomosynthesis and histopathological findings. The size evaluation determined by digital breast tomosynthesis was more accurately correlated with that found by pathology; the calculated Pearson's correlation coefficient of digital breast tomosynthesis and digital mammography to the pathologically determined tumor-free resection margins were 0.92 and 0.79 in CC view and 0.92 and 0.72 in LL view, respectively. Compared with the pathologically determined tumor-free resection margins, the size determined by both imaging modalities was, on average, overestimated. Bland-Altman analysis showed an excellent inter readers agreement.
Digital breast tomosynthesis is more accurate in assessment of margin status than digital mammography; it could be a more accurate technique than full-field digital mammography for the intraoperative delineating of tumor resection margins.
我们研究了数字乳腺断层合成摄影术与全数字化乳腺钼靶摄影术在评估保乳手术术中标本肿瘤切缘的准确性，以降低再次切除率。
共纳入 170 例经证实患有乳腺癌且适合行保乳手术的患者。术中标本行数字乳腺钼靶摄影术和数字乳腺断层合成摄影术检查。两名具有 10 年乳腺影像学经验的放射科医生以批处理模式评估无肿瘤切缘和切缘与病灶之间的距离。组织病理学检查结果被视为参考标准。
我们使用相关分析评估了数字乳腺钼靶摄影术和数字乳腺断层合成摄影术测量的无肿瘤切缘与真实值（组织病理学检查结果）之间的一致性，以及数字乳腺断层合成摄影术与组织病理学检查结果之间的一致性。数字乳腺断层合成摄影术评估的大小与病理结果更相关；数字乳腺断层合成摄影术和数字乳腺钼靶摄影术在 CC 视图和 LL 视图下与病理确定的无肿瘤切缘的计算 Pearson 相关系数分别为 0.92 和 0.79，0.92 和 0.72。与病理确定的无肿瘤切缘相比，两种影像学方法确定的大小平均存在高估。Bland-Altman 分析显示了良好的读者间一致性。
数字乳腺断层合成摄影术在评估切缘状态方面比数字乳腺钼靶摄影术更准确；它可能是一种比全数字化乳腺钼靶摄影术更准确的技术，可用于术中肿瘤切除边界的描绘。
