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最小化保乳手术后的再次切除 - 实时、术中边缘评估的射频光谱学综述。

Minimizing re-excision after breast conserving surgery - a review of radiofrequency spectroscopy for real-time, intraoperative margin assessment.

机构信息

Director of Surgical Oncology, Medical Director, Hall-Perrine Cancer Center, Cedar Rapids, IA - Clinical Associate Professor of Surgery at the University of Iowa Hospitals and Clinics, USA.

Department of Surgery, Ascension St. John Hospital and Medical Center, Detroit, MI - Clinical Associate Professor of Surgery, Wayne State University College of Medicine, St. George's University College of Medicine, USA.

出版信息

Expert Rev Med Devices. 2021 Nov;18(11):1057-1068. doi: 10.1080/17434440.2021.1992273. Epub 2021 Nov 1.

Abstract

INTRODUCTION

For early-stage breast cancer, breast-conserving surgery (BCS) plus radiation is standard-of-care. Nationwide, >20% of BCS patients require re-excision for positive margins, resulting in delayed adjuvant therapy, increased complications, emotional and financial stress for patients, and additional cost to the healthcare system. Although several methods may be employed to mitigate positive margins, no technique can fully address the need. MarginProbe® is an adjunctive tool for real-time intraoperative margin assessment and is shown to reduce positive margins by >50%.

AREAS COVERED

Discussion of the impact of re-excision following BCS, a review of currently available methods for intraoperative margin management, followed by a technology and literature review of the MarginProbe® Radiofrequency Spectroscopy System.

EXPERT OPINION

Re-excision significantly impacts patients, providers and payers. Limitations in the ability to assess margins at time of surgery warrant more advanced methods of residual disease detection. MarginProbe facilitates the most efficient pathway for breast cancer patients through the surgical phase of treatment. The device is well-suited for adoption as the healthcare focus shifts from volume to value and supports the three pillars of the US Department of Health and Human Services' 'Triple-Aim' strategy: improve population health, improve patient experience of care, and reduce per-capita costs.

摘要

简介

对于早期乳腺癌,保乳手术(BCS)加放疗是标准治疗方法。在全国范围内,超过 20%的 BCS 患者因切缘阳性需要再次切除,导致辅助治疗延迟、并发症增加、患者的情绪和经济压力以及医疗保健系统的额外成本。尽管可以采用几种方法来减轻阳性切缘,但没有一种技术可以完全满足需求。MarginProbe®是一种辅助工具,用于实时术中切缘评估,据报道可将阳性切缘减少>50%。

涵盖的领域

讨论 BCS 后再次切除的影响,回顾目前术中切缘管理的可用方法,然后对 MarginProbe®射频光谱系统进行技术和文献回顾。

专家意见

再次切除对患者、提供者和支付者都有重大影响。手术时评估切缘能力的局限性需要更先进的残留疾病检测方法。MarginProbe 通过治疗的手术阶段为乳腺癌患者提供最有效的途径。该设备非常适合采用,因为医疗保健的重点从数量转向价值,并支持美国卫生与公众服务部“三重目标”战略的三个支柱:改善人口健康、改善患者的护理体验和降低人均成本。

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