Highlights
- •This is one of the only studies to evaluate the effect of intraoperative three-dimensional (3-D) tomosynthesis on breast conservation therapy (BCT).
- •The focus of this study was the impact of 3-D tomosynthesis on positive margin rates with BCT.
- •The main analysis found no significant difference in the margin positivity rates between 3-D tomosynthesis and standard imaging.
- •The secondary measures also found no benefit with the use of intraoperative 3-D tomosynthesis.
Abstract
Background
Breast conservation therapy (BCT) is frequently performed for breast cancer and associated
with a significant risk for positive margins. Intraoperative three-dimensional (3-D)
tomosynthesis potentially could limit the risk of positive margins.
Methods
Retrospective review of an institutional breast cancer registry. Evaluated BCT cases
for a two year time period prior to and after the introduction of intraoperative 3-D
tomosynthesis. Primary outcome was the effect of 3-D tomosynthesis on margin positivity
rates. Secondary measures were the impact of 3-D tomosynthesis on additional margin
procurements at the index surgery and operative time.
Results
A total of 228 cases were evaluated with 106 cases utilizing 3-D tomosynthesis and
122 cases with standard imaging. No significant difference in margin positivity rates
between the cohorts at 23.9% versus 15.8% for 3-D tomosynthesis and standard imaging
respectively (OR 1.53, CI 0.772–3.032, P = 0.221). 3-D tomosynthesis was associated
with increased margin procurement rates (OR 2.34, 95%CI 1.303–4.190, P = 0.004) and
longer operative times (P < 0.001).
Conclusion
Intraoperative 3-D tomosynthesis was not found to limit margin positivity rates or
improve the performance of the procedure.
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Article info
Publication history
Published online: December 28, 2022
Accepted:
December 26,
2022
Received in revised form:
December 4,
2022
Received:
October 18,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
