BR191-ED-X

Intraoperative Specimen Radiography- Going Beyond the Block

All Day Location: BR Community, Learning Center



Beatriz E. Adrada, MD, Houston, TX (Presenter) Nothing to Disclose
Monica L. Huang, MD, Houston, TX (Abstract Co-Author) Nothing to Disclose
Rosalind P. Candelaria, MD, Houston, TX (Abstract Co-Author) Nothing to Disclose
Lumarie Santiago, MD, Houston, TX (Abstract Co-Author) Nothing to Disclose
Gaiane M. Rauch, MD, PhD, Houston, TX (Abstract Co-Author) Nothing to Disclose
Elsa M. Arribas, MD, Houston, TX (Abstract Co-Author) Nothing to Disclose
Deborah J. Dawson, BS, RT, Houston, TX (Abstract Co-Author) Nothing to Disclose
Constance Albarracin, Houston, TX (Abstract Co-Author) Nothing to Disclose
Tanya W. Moseley, MD, Houston, TX (Abstract Co-Author) Nothing to Disclose
Gary J. Whitman, MD, Houston, TX (Abstract Co-Author) Book contract, Cambridge University Press
TEACHING POINTS

1. Positive surgical margins in breast conserving surgery (BCS) for ductal carcinoma in situ (DCIS) and invasive breast carcinomas are the strongest predictors for local recurrence.2. Optimally, clear margins should be obtained with the first surgical procedure. However, re-excision rates in BCS for DCIS have been reported to range from 21 to 50%.3. There are different techniques such as intraoperative specimen radiography, imprint cytology and frozen section analysis to ensure complete microscopic clearance of the surgical margins, leading to reduced re-excision rates. 4. Appropriate interpretation of specimen radiographs to confirm removal of targeted tumors, marker clips, needles, wires, and radioactive seeds and to ensure clear margins is extremely important.

TABLE OF CONTENTS/OUTLINE

1. How to optimize the handling of the specimen by the pathologist. 2. En bloc and sliced specimen radiographs. 3. Electronic transmission of specimen radiography images. 4. Specimen radiography case presentations: the critical role of the radiologist in achieving negative surgical margins.