Mastectomy Research Today is a free monthly online journal that collates and summarizes the latest research about Mastectomy, including details on breast cancer, prosthesis, recovery, surgery, complications.

Intra-operative assessment of excision margins using breast imprint and scrape cytology.

Muttalib M, Tai CC, Briant-Evans T, Maheswaran I, Livni N, Shousha S, Sinnett HD

Department of Breast Surgery, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK. masoom@orange.net

Local recurrence in breast cancer surgery is related to the completeness of excision. Histological analysis of excision margins is time consuming and impractical for use intra-operatively. Our group evaluated breast imprint and scrape cytology (ISC) for the assessment of excision margins in a feasibility study in 1993-4, with 10 year clinical follow-up. Twenty-six consecutive women undergoing 27 wide local excisions for breast cancer had excision margins prospectively assessed with intra-operative ISC blinded to histology. All ISC results were ready (range 22-30 min) before surgery was completed. ISC agreed with histology in 21/27 (=78%) and disagreed in 6/27 (=22%) of the cases. In two cases with local recurrence, histology was positive in one case, whereas ISC margins were positive in both. Intra-operative ISC is reliable and could help the surgeon to excise more tissue to prevent a second (re-excision) operation. ISC margins may predict clinical outcome, although a larger interventional follow-up study is required.

Published 7 February 2005 in Breast, 14(1): 42-50.
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