Vartanian Artin, Papas Paraskevi V, Guarecuco Castillo Jesus E, Sistare Michael, Masri Mohammed M
General Surgery, St. George's University School of Medicine, St. George's, GRD.
General Surgery, Larkin Community Hospital, South Miami, USA.
Cureus. 2023 Jul 10;15(7):e41662. doi: 10.7759/cureus.41662. eCollection 2023 Jul.
Breast-conserving surgery (BCS) is becoming an increasingly preferred surgical technique for treating breast cancer. For the last several decades, using a preoperative wire placed by a radiologist has been the gold standard to help guide surgeons to excise a suspicious mass. In recent years, there has been an increasing focus on using surgeon-performed intraoperative ultrasound (IOUS) during breast-conserving therapy, suggesting improved cosmetic outcomes and a decreased need for re-excision. However, studies have also highlighted that ultrasound may be uncomfortable for surgeons who have become most familiar with a wire-localization technique. Wire localization and intraoperative ultrasound are valuable tools that can improve the accuracy of tumor localization and reduce the need for re-excision. We present a 45-year-old female with a right breast mass, measuring breast imaging reporting and data system (BIRADS) 4A on preoperative ultrasound. Intraoperative wire-localization was performed by the surgeon utilizing ultrasound guidance. The right breast lesion was successfully excised with negative margins. The patient was discharged home and recovered well. Surgeon-performed intraoperative ultrasound can be combined with surgeon-performed wire localization to reduce the need for re-excision surgery and allow the surgeon to retain the familiarity of utilizing a gold-standard technique. Further research is needed to determine the optimal use of surgeon-performed IOUS and wire-localization, and its impact on long-term outcomes.
保乳手术（BCS）正日益成为治疗乳腺癌更受青睐的手术技术。在过去几十年里，使用放射科医生术前放置的导丝一直是帮助引导外科医生切除可疑肿块的金标准。近年来，在保乳治疗期间越来越关注使用外科医生实施的术中超声（IOUS），这表明美容效果有所改善且再次切除的需求减少。然而，研究也强调，对于那些最熟悉导丝定位技术的外科医生来说，超声可能会让他们感到不适。导丝定位和术中超声是有价值的工具，可提高肿瘤定位的准确性并减少再次切除的需求。我们报告一位45岁女性，术前超声检查显示右乳肿块，乳腺影像报告和数据系统（BIRADS）分类为4A。外科医生在超声引导下进行了术中导丝定位。成功切除了右侧乳腺病变，切缘阴性。患者出院回家，恢复良好。外科医生实施的术中超声可与外科医生实施的导丝定位相结合，以减少再次切除手术的需求，并让外科医生保持对使用金标准技术的熟悉度。需要进一步研究以确定外科医生实施的IOUS和导丝定位的最佳使用方式及其对长期结果的影响。
