Reinhard Kubale MD, Presenter: Nothing to Disclose

Birgit Dohmen, Abstract Co-Author: Nothing to Disclose

Bernd Seelbinder MD, Abstract Co-Author: Nothing to Disclose

Alexander Massmann MD, Abstract Co-Author: Nothing to Disclose

Kurt Scherer MD, Abstract Co-Author: Nothing to Disclose

Arno Buecker MD, Abstract Co-Author: Consultant, ev3 Inc Speaker, ev3 Inc Co-founder, Aachen Resonance GmbH

Abdolhamid Huschmand Nia MD, Abstract Co-Author: Nothing to Disclose

To evaluate the role of ex vivo high resolution ultrasound of breast cancer tissue for the reduction of re-excision rate in breast conserving surgery.

We developed a tissue transfer and X-ray system (T-TRAX), which allows a topographic correct transfer of the tissue for ex vivo determination of tumor margins by radiologists and later by pathologist. T-TRAX reliably ensures precise localization of the tumor within the excised tissue by tissue-ultrasound and tissue-radiographs (anterior-posterior and cranio-caudal). Once pinned to tray by surgeons all examiners including the pathologists see the excised tissue as seen by the surgeons during surgery. 214 tumors were included (pTis 8,9%, pT1a 4.2 %, pT1b 17,8%, pT1c 48,6%, pT2 20,5%) using an 18 MHz linear transducer (Siemens S2000). The sonographic measurements of free margin were correlated with histological measurements of the tumor free margin.

In 86% a free margin was achieved at primary surgery. Additional excisions during primary surgery according to tissue ultrasound and tissue radiographs were performed in 55.6 % and were in 30% relevant for achieving free margins and reduced our re-excision rate significantly. The total re-excision was 14%. In situ carcinomas accounted for 10.8% of re-excisions. Only 3.2 % of re-excisions were due to low margins for Invasive carcinomas.

Ex vivo high resolution ultrasound and radiological examination of breast cancer tissue can help reduce the re-excision rate for low or positive margins significantly.

Ex vivo high resolution ultrasound of breast cancer tissue can help to reduce the re-excision rate for too small or positive margins.

Kubale, R, Dohmen, B, Seelbinder, B, Massmann, A, Scherer, K, Buecker, A, Huschmand Nia, A, High-Resolution Ultrasound-guided Surgery of Nonpalpable Breast Lesions.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034338.html