Narumi Harada PhD, Presenter: Nothing to Disclose

Takanori Ishida, Abstract Co-Author: Nothing to Disclose

Takayuki Yamada MD, PhD, Abstract Co-Author: Nothing to Disclose

Takuya Moriya, Abstract Co-Author: Nothing to Disclose

Shoki Takahashi MD, Abstract Co-Author: Nothing to Disclose

Noriaki Ohuchi, Abstract Co-Author: Nothing to Disclose

There have not been enough data for detecting an appropriate excision area for breast conserving surgery (BCS). The purpose was to assess the clinical significance of multidetector-row helical computed tomography (MD-CT) for detecting cancer extension and the decision of the excision area with CT skin marker for BCS.

We enrolled 102 consecutive cases from May, 2005 to February, 2007 with early breast cancer, who underwent MD-CT with CT skin marker before BCS. We predicted an area of interest by mammography and ultrasound, and placed CT skin marker with seven non-lead lines (CT-SPOTS® Beekly GUIDELINES CT -117) on the body surface. 16-detector row MD-CT (SOMATOM Sensation Cardiac, Siemens Medical Systems) was used. All the patients were in the supine position and injected with 2mL/kg of nonionic contrast material in 30 seconds. The first scan was obtained 60 sec after commencing contrast injection; the second scan was obtained at a 150 sec delay from start of injection. Radiologists made multiplanar reformats and a preoperative lesion mapping image using maximum intensity projection (MIP) and shaded surface display (SSD). We extended the lumpectomy and quadrantectomy based on the MD-CT images. Serial 5mm-thick slices were made from the specimen and the pathological results were mapped. Positive surgical margin was defined as any cancer transected at the margin less than 5mm.

MD-CT detected 97 breast lesions (97 of 102 cases, 95.1%). There were undetectable 5 cases, and all cases had histological low nuclear grade ductal carcinoma in situ (DCIS). In the series of this study, 6 of 97 cases (6.2%) had a positive surgical margin; their corresponding rates without CT skin marker were 37 of 280 cases (13.2%). MD-CT with skin marker evaluation achieved reduction of positive surgical margin by approximately 50%.

MD-CT with skin marker can provide appropriate information for the determination of adequate surgical margin and contribute to increase in breast conservation rates.

MD-CT with skin marker should be considered as a valid tool for the preoperative assessment of patients undergoing breast conserving surgery.

Harada, N, Ishida, T, Yamada, T, Moriya, T, Takahashi, S, Ohuchi, N, Multidetector-Row Helical Computed Tomography with Skin Marker for a Decision on the Extent of Resection in Breast Conserving Surgery.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5006430.html