A novel ultrasound-guided electrosurgical loop device for intra-operative excision of breast lesions; an improvement in surgical technique

Abstract 

Background

The rate of involved margins after the excision of breast lesions using standard surgical techniques has historically ranged from approximately 20% to 45%. The localization and excision of breast lesions using intraoperative ultrasound has provided significant improvement. The authors report their collective experience with a novel technique utilizing the Phantom flexible loop electrosurgical device under ultrasound guidance for the intraoperative excision of breast lesions.

Methods

Seventy-nine breast lesions were excised using the Phantom device with intraoperative ultrasound. Rate of reexcision, excised specimen size, and size of the lumpectomy incision were reviewed.

Results

Fifty-nine of 79 lesions were malignant. Fifty-one (86.4%) had noninvolved final margins; 8 (13.6%) involved margins. The average specimen size was 21.3 cm³, compared with a range of 60 to 100 cm³ in the literature.

Conclusions

These results demonstrate improved efficiency, a decrease in the volume of excision, smaller incision size, and very low need for reoperation secondary to involved margins using the Phantom device for real-time, ultrasound-guided lumpectomy.

Keywords: Ultrasound, Lumpectomy, Breast-conserving surgery, Phantom flexible loop, Electrosurgical device, Margins, Biopsy