Evidence map›Paper›PMID 29947001›Full record

Trial reportAnnals of surgical oncology2018

Multidisciplinary Intraoperative Assessment of Breast Specimens Reduces Number of Positive Margins.

S E Tevis, H B Neuman, E A Mittendorf, H M Kuerer, I Bedrosian, S M DeSnyder, A M Thompson, D M Black, M E Scoggins, A A Sahin and 2 more

Abstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Annals of surgical oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Article
  3. Effectiveness and Safety of Magseed-localization for Excision of Breast Lesions: A Prospective, Phase IV Trial.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2020
    Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

S E TevisDepartment of Breast Surgical Oncology, University of Texas- MD Anderson Cancer Center, Houston, TX, USA.
H B NeumanUniversity of Wisconsin, Madison, WI, USA.
E A MittendorfDepartment of Breast Surgical Oncology, University of Texas- MD Anderson Cancer Center, Houston, TX, USA.
H M KuererDepartment of Breast Surgical Oncology, University of Texas- MD Anderson Cancer Center, Houston, TX, USA.
I BedrosianDepartment of Breast Surgical Oncology, University of Texas- MD Anderson Cancer Center, Houston, TX, USA.
S M DeSnyderDepartment of Breast Surgical Oncology, University of Texas- MD Anderson Cancer Center, Houston, TX, USA.
A M ThompsonDepartment of Breast Surgical Oncology, University of Texas- MD Anderson Cancer Center, Houston, TX, USA.
D M BlackDepartment of Breast Surgical Oncology, University of Texas- MD Anderson Cancer Center, Houston, TX, USA.
M E ScogginsDepartment of Breast Surgical Oncology, University of Texas- MD Anderson Cancer Center, Houston, TX, USA.
A A SahinDepartment of Breast Surgical Oncology, University of Texas- MD Anderson Cancer Center, Houston, TX, USA.
K K HuntDepartment of Breast Surgical Oncology, University of Texas- MD Anderson Cancer Center, Houston, TX, USA.
A S CaudleDepartment of Breast Surgical Oncology, University of Texas- MD Anderson Cancer Center, Houston, TX, USA. ascaudle@mdanderson.org.

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Fabien Delerue · 1985 to 2026
$290.8M
Cancer Center Support Grant (NIH) CA16672NCI NIH HHS P30 CA016672
6 · The paper itself

Abstract

backgroundSuccessful breast-conserving surgery requires achieving negative margins. At our institution, the whole surgical specimen is imaged and then serially sectioned with repeat imaging. A multidisciplinary discussion then determines need for excision of additional margins. The goal of this study was to determine the benefit of each component of this approach in reducing the number of positive margin.

methodsThis single-institution, prospective study included ten breast surgical oncologists who were surveyed to ascertain whether they would have taken additional margins based their review of whole specimen images (WSI) and review of serially sectioned images (SSI). These results were compared with the multidisciplinary decisions (MDD) and pathology results. Margin status was defined using consensus guidelines.

resultsOne hundred surveys were completed. Margins on the original specimen were positive or close in 21%. After WSI, surgeons reported that they would have taken additional margins in 26 cases, reducing the number of positive/close margins from 21 to 13% (p < 0.001). After SSI, 52 would have taken additional margins; however, the number of positive/close margins remained 13%. MDD resulted in additional margins taken in 56 cases, reducing the number of positive/close margins to 7% (p < 0.001 compared with SSI).

conclusionsWhile surgeon review of specimen radiographs can decrease the number of positive or close margins from 21 to 13%, more rigorous multidisciplinary, intraoperative margin assessment reduces the number of close or positive margins to 7%.

Indexed as

Breast NeoplasmsFemaleFollow-Up StudiesHumansImage Processing, Computer-AssistedIntraoperative CareMastectomy, SegmentalNeoplasm, ResidualPrognosisProspective StudiesRisk Assessment

Identifiers

PMID29947001
PMCPMC6123252

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.