ArticleSpringerPlus2015
The impact of use of an intraoperative margin assessment device on re-excision rates.
Article in SpringerPlus, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Reducing re-excision rates in breast conserving surgery with Margin Probe: systematic review.The British journal of surgery · 2024Pooled it
- Evaluating the Effect of MarginProbeAnnals of surgical oncology · 2024Article
- Cost minimization in breast conserving surgery: a comparative study of radiofrequency spectroscopy and full cavity shave margins.Cost effectiveness and resource allocation : C/E · 2023Article
- Development of intraoperative assessment of margins in breast conserving surgery: a narrative review.Gland surgery · 2022Review
- Accuracy of gross intraoperative margin assessment for breast cancer: experience since the SSO-ASTRO margin consensus guidelines.Scientific reports · 2020Article
- Neutral diagnosis: An innovative concept for medical device clinical trials.Contemporary clinical trials communications · 2019Article
- Update of the American Society of Breast Surgeons Toolbox to address the lumpectomy reoperation epidemic.Gland surgery · 2018Review
- Article
- Using DRS during breast conserving surgery: identifying robust optical parameters and influence of inter-patient variation.Biomedical optics express · 2016Article
- Toolbox to Reduce Lumpectomy Reoperations and Improve Cosmetic Outcome in Breast Cancer Patients: The American Society of Breast Surgeons Consensus Conference.Annals of surgical oncology · 2015Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Historically there has been a high rate of surgical interventions to obtain clear margins for breast cancer patients undergoing breast conserving local therapy. An intraoperative margin assessment tool (MarginProbe) has been approved for use in the US since 2013. This study is the first compilation of data from routine use of the device, to assess the impact of device utilization on re-excision rates. We present a retrospective, observational, review from groups of consecutive patients, before and after the implementation of intraoperative use of the device during lumpectomy procedures. Lesions were localized by standard methods. The intraoperative margin assessment device was used on all circumferential margins of the main specimen, but not on any additional shavings. A positive reading by the device led to an additional shaving of the corresponding cavity location. Specimens were also, when feasible, imaged intra-operatively by X-ray, and additional shavings were taken if needed based on clinical assessment. For each surgeon, historical re-excision rates were established based on a consecutive set of patients from a time period proximal to initiation of use of the device. From March 2013 to April 2014 the device was routinely used by 4 surgeons in 3 centers. In total, 165 cases lumpectomy cases were performed. Positive margins resulted in additional re-excision procedures in 9.7% (16/165) of the cases. The corresponding historical set from 2012 and 2013 consisted of 186 Lumpectomy cases, in which additional re-excision procedures were performed in 25.8% (48/186) of the cases. The reduction in the rate of re-excision procedures was significant 62% (P < 0.0001). Use of an intraoperative margin assessment device contributes to achieving clear margins and reducing re-excision procedures. As in some cases positive margins were found on shavings, future studies of interest may include an analysis of the effect of using the device on the shavings intra-operatively.
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Registered trials
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