The American Journal of Surgery
Volume 196, Issue 4 , Pages 483-489 , October 2008

A prospective, randomized, controlled, multicenter study of a real-time, intraoperative probe for positive margin detection in breast-conserving surgery

  • Tanir M. Allweis, M.D.

      Affiliations

    • Hadassah Hebrew University Medical Center, Jerusalem, Israel
    • Corresponding Author InformationCorresponding author. Tel.: +972-2-5844111; fax: +972-2-5844232
    • ,
  • Zvi Kaufman, M.D.

      Affiliations

    • Meir General Hospital, Kfar-Saba, Israel
    • ,
  • Shlomo Lelcuk, M.D.

      Affiliations

    • Rabin Medical Center, Belinson Campus, Petah-Tikva, Israel
    • ,
  • Itzhak Pappo, M.D.

      Affiliations

    • Assaf-Harofeh Medical Center, Zrifin Beer-Yaakov, Israel
    • ,
  • Tami Karni, M.D.

      Affiliations

    • Assaf-Harofeh Medical Center, Zrifin Beer-Yaakov, Israel
    • ,
  • Shlomo Schneebaum, M.D.

      Affiliations

    • Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
    • ,
  • Rona Spector, M.D.

      Affiliations

    • Rabin Medical Center, Belinson Campus, Petah-Tikva, Israel
    • ,
  • Asher Schindel, M.D.

      Affiliations

    • Rabin Medical Center, Belinson Campus, Petah-Tikva, Israel
    • ,
  • Dan Hershko, M.D.

      Affiliations

    • Rambam Medical Center, Haifa, Israel
    • ,
  • Moshe Zilberman, M.D.

      Affiliations

    • The Baruch Padeh Medical Center, Poriya, Israel
    • ,
  • Joel Sayfan, M.D.

      Affiliations

    • Haemek Medical Center, Afula, Israel
    • ,
  • Yuri Berlin, M.D.

      Affiliations

    • Haemek Medical Center, Afula, Israel
    • ,
  • Amram Hadary, M.D.

      Affiliations

    • Sieff Government Hospital, Safed, Israel
    • ,
  • Oded Olsha, M.D.

      Affiliations

    • Shaare Zedek Medical Center, Jerusalem, Israel
    • ,
  • Haim Paran, M.D.

      Affiliations

    • Meir General Hospital, Kfar-Saba, Israel
    • ,
  • Mordechai Gutman, M.D.

      Affiliations

    • Meir General Hospital, Kfar-Saba, Israel
    • ,
  • Moshe Carmon, M.D.

      Affiliations

    • Shaare Zedek Medical Center, Jerusalem, Israel

Received 23 April 2008 ,Revised 29 May 2008

References 

  1. Newman LA, Washington TA. New trends in breast conservation therapy. Surg Clin North Am. 2003;83:841–883
  2. Morrow M, Strom EA, Bassett LW, et al. Standard for breast conservation therapy in the management of invasive breast carcinoma. CA Cancer J Clin. 2002;52:277–300
  3. Gentilini O, Intra M, Gandini S, et al. Ipsilateral breast tumor reappearance in patients treated with conservative surgery after primary chemotherapy (The role of surgical margins on outcome). J Surg Oncol. 2006;94:375–379
  4. Smitt MC, Nowels K, Carlson RW, et al. Predictors of reexcision findings and recurrence after breast conservation. Int J Radiat Oncol Biol Phys. 2003;57:979–985
  5. Huston TL, Simmons RM. Locally recurrent breast cancer after conservation therapy. Am J Surg. 2005;189:229–235
  6. Leong C, Boyages J, Jayasinghe UW, et al. Effect of margins on ipsilateral breast tumor recurrence after breast conservation therapy for lymph node-negative breast carcinoma. Cancer. 2004;100:1823–1832
  7. McCready DR. Keeping abreast of marginal controversies. Ann Surg Oncol. 2004;11:885–887
  8. Tafra L, Fine R, Whitworth P, et al. Prospective randomized study comparing cryo-assisted and needle-wire localization of ultrasound visible breast tumors. Am J Surg. 2006;192:462–470
  9. Menes TS, Tartter PA, Bleiweiss I, et al. The consequence of multiple re-excisions to obtain clear lumpectomy margins in breast cancer patients. Ann Surg Oncol. 2005;12:1–5
  10. McLaughlin SA, Ochoa-Frongia LM, Patil SM, et al. Influence of frozen-section analysis of sentinel lymph node and lumpectomy margin status on reoperation rates in patients undergoing breast-conservation therapy. J Am Coll Surg. 2008;206:76–82
  11. Mullenix PS, Cuadrado DG, Steele SR, et al. Secondary operations are frequently required to complete the surgical phase of therapy in the era of breast conservation and sentinel lymph node biopsy. Am J Surg. 2004;187:643–646
  12. NCCN Clinical Practice Guidelines in Oncology 2007. National Comprehensive Cancer Network.
  13. Singletary SE. Surgical margins in patients with early-stage breast cancer with breast conservation surgery. Am J Surg. 2002;184:383–393
  14. Taghian A, Mohiuddin M, Jagsi R, et al. Current perceptions regarding surgical margin status after breast-conserving therapy: results of a survey. Ann Surg. 2005;241:629–639
  15. Silverstein MJ, Lagios MD, Groshen S, et al. The influence of margin width on local control of ductal carcinoma in situ of the breast. N Engl J Med. 1999;340:1455–1461
  16. Chagpar A, Yen T, Sahin A, et al. Intraoperative margin assessment reduces reexcision rates in patients with ductal carcinoma is situ treated with breast conserving surgery. Am J Surg. 2003;186:371–377
  17. Keskek M, Kotharia M, Ardehalia B, et al. Factors predisposing to cavity margin positivity following conservation surgery for breast cancer. Eur J Surg Oncol. 2004;30:1058–1064
  18. Cabioglu N, Hunt KK, Sahin AA, et al. Role for intraoperative margin assessment in patients undergoing breast conserving surgery. Ann Surg Oncol. 2007;14:1458–1471
  19. Klimberg VS, Harms S, Korourian S. Assessing margin status. Surg Oncol. 1999;8:77–84
  20. Karni T, Pappo I, Sandbank J, et al. A device for real-time, intraoperative margin assessment in breast-conservation surgery. Am J Surg. 2007;194:467–473

 Supported by Dune Medical Devices, Caesarea, Israel.

PII: S0002-9610(08)00487-X

doi: 10.1016/j.amjsurg.2008.06.024

The American Journal of Surgery
Volume 196, Issue 4 , Pages 483-489 , October 2008

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