Volume 15 Supplement 1

British Society of Breast Radiology Annual Scientific Meeting 2013

Open Access

PB.20: Accuracy of specimen radiograph in determining lesion presence in excised specimens, correlating histological and radiological margins

  • L Sundaram1,
  • N Hartley1,
  • M Hoosein1,
  • M Al-Attar1,
  • E Denton1,
  • L Grosvenor1,
  • D Lister1,
  • G McDonald1 and
  • S Kaneri1
Breast Cancer Research201315(Suppl 1):P20

https://doi.org/10.1186/bcr3520

Published: 8 November 2013

Introduction

Radiography of the excised specimen post localisation determines whether the target lesion has been removed [1]. The surgical specimen is oriented and if a margin appears suspicious on imaging, further tissue is removed [2]. An incompletely excised carcinoma adds to further surgical workload, psychological and physical morbidity for patients.

Methods

All patients with biopsy-proven carcinoma undergoing therapeutic excision over a 16-month period were reviewed. A retrospective review of the mammographic lesion localised, visualisation on specimen radiograph (SR), SR report on adequacy, margins of excision, histology of tumour, margins after WLE and further surgery (including minimum distances on margins) was performed and recorded.

Results

Of 68 therapeutic wire-guided excisions, lesion was accurately detected in SR in 67/68 cases (99%), comparable with the published literature. In 53/68, no more excision was recommended on imaging. Of these, histology confirmed clear margins in 45/68. Further immediate excision was correctly advised in 15 patients. New excision margins were clear in 10/15 cases, thus avoiding second surgery for this subgroup. Extensive disease was seen despite re-excision in five patients. Accuracy of commenting on tumour at margins was 60/68 (88%).

Conclusion

Discrepancy between radiological and histological margins has significant implications. Accurate SR interpretation is vital. Meticulous attention to the protocol will reduce errors.

Authors’ Affiliations

(1)
Breast Care Centre, Glenfield Hospital, UHL

References

  1. Quality Assurance Guidelines in Breast Cancer Screening. 2003, NHSBSP Publication Number 20. Sheffield: NHS Cancer Screening Programmes, 3Google Scholar
  2. White J, et al: Compliance with breast conservation standards for patients with early breast carcinoma. Cancer. 2003, 97: 893-904. 10.1002/cncr.11141.View ArticlePubMedGoogle Scholar

Copyright

© Sundaram et al.; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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