Department of Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, South Korea.
Department of Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, South Korea.
Asian J Surg. 2023 May;46(5):1931-1936. doi: 10.1016/j.asjsur.2022.09.094. Epub 2022 Oct 15.
Although breast surgeons can request frozen section biopsies to evaluate margin status in breast-conserving surgery (BCS), specimen imaging is also a useful assessment tool. Intraoperative digital specimen mammography (IDSM) has recently been introduced in Korea. To estimate the clinical role of IDSM, this study compared the clinicopathologic factors of patients whose specimen was assessed with IDSM with those assessed using conventional specimen mammography (CSM).
From October to December 2021, 78 breast cancer patients who underwent BCS were included in this study. The obtained specimens were assessed using IDSM (n = 44) and CSM (n = 34). Clinicopathologic factors included margin involvement status in specimen mammography and the results of frozen section biopsies. The radiation dose emitted from the specimen after mammography was measured using a portable device.
There were no significant differences in clinicopathological factors between the two groups, except the type of surgery for axillary lymph nodes. The closest distance from the margin to tumor was longer in the CSM group than in the IDSM group, although the difference was not statistically significant (p = 0.894). Margin involvement was accurately detected using IDSM due to the absence of compression (p < 0.001). In addition, the sensitivity and accuracy of IDSM were higher, and the false-negative rate was lower.
Both specimen mammography methods were highly accurate in evaluating the margin involvement status. However, the margin status could be examined more precisely using IDSM because the specimen was not compressed to perform the examination. Because the IDSM system was installed in the operating room, it not only shortened performing routes but also reduced the operating time by providing immediate results.
尽管乳腺外科医生可以要求进行冷冻切片活检以评估保乳手术 (BCS) 中的切缘状态，但标本成像也是一种有用的评估工具。术中数字标本乳腺 X 线摄影术 (IDSM) 最近在韩国推出。为了评估 IDSM 的临床作用，本研究比较了使用 IDSM 评估标本的患者与使用传统标本乳腺 X 线摄影术 (CSM) 评估标本的患者的临床病理因素。
本研究纳入了 2021 年 10 月至 12 月期间接受 BCS 的 78 例乳腺癌患者。获得的标本分别使用 IDSM（n=44）和 CSM（n=34）进行评估。临床病理因素包括标本乳腺 X 线摄影术的切缘受累状态和冷冻切片活检的结果。使用便携式设备测量乳腺 X 线摄影术后标本发出的辐射剂量。
除腋窝淋巴结手术类型外，两组患者的临床病理因素无显著差异。CSM 组标本的切缘到肿瘤的最近距离大于 IDSM 组，尽管差异无统计学意义（p=0.894）。由于不存在压迫，IDSM 可准确检测到切缘受累（p<0.001）。此外，IDSM 的敏感性和准确性更高，假阴性率更低。
两种标本乳腺 X 线摄影方法在评估切缘受累状态方面均具有高度准确性。然而，由于标本未受压进行检查，因此使用 IDSM 可以更精确地检查切缘状态。由于 IDSM 系统安装在手术室中，不仅缩短了操作路径，还通过提供即时结果缩短了手术时间。
