Evidence map›Paper›PMID 42329454›Full record

ArticleBreast cancer research and treatment2026

Surgeon interpretation of margin status utilizing intraoperative 3D tomosynthesis during breast-conserving surgery.

Laura D Leonard, Ethan Cohen, Rachel Perry, Jia Sun, Richie Ehlers, Ana Refinetti, Helen M Johnson, Catherine Akay, Jessica Suarez Colen, Sarah DeSnyder and 5 more

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Article in Breast cancer research and treatment, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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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

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

15 authors.

Laura D LeonardDepartment of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, Tx, 77230, USA.
Ethan CohenDepartment of Breast Imaging, University of Texas MD Anderson Cancer Center, Houston, Tx, USA.
Rachel PerryDepartment of Breast Imaging, University of Texas MD Anderson Cancer Center, Houston, Tx, USA.
Jia SunDepartment of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, Tx, USA.
Richie EhlersDepartment of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, Tx, 77230, USA.
Ana RefinettiDepartment of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, Tx, 77230, USA.
Helen M JohnsonDepartment of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, Tx, 77230, USA.
Catherine AkayDepartment of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, Tx, 77230, USA.
Jessica Suarez ColenDepartment of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, Tx, 77230, USA.
Sarah DeSnyderDepartment of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, Tx, 77230, USA.
Fedra FallahianDepartment of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, Tx, 77230, USA.
Rosa HwangDepartment of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, Tx, 77230, USA.
Kelly K HuntDepartment of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, Tx, 77230, USA.
Yun WuDepartment of Breast Pathology, University of Texas MD Anderson Cancer Center, Houston, Tx, USA.
Nina TamirisaDepartment of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, Tx, 77230, USA. NTamirisa@mdanderson.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionObtaining negative margins at the time of segmental mastectomy (SM) is important to reduce risk of local recurrence and avoid the need for a second surgery due to positive margins. Our current institutional standard practice (ISP) includes intraoperative assessment of the gross specimen and specimen radiographs by a multidisciplinary team including radiologists and pathologists.

methodsIn this study, we utilized digital breast tomosynthesis (DBT) images of SM specimens in the operating room and recorded when additional (selective) shave margins were proposed by the surgeon. A breast radiologist later reviewed the archived DBT images. The timing and accuracy of surgeon and breast radiologists' margin assessment using DBT was then compared to our ISP.

resultsThere were 193 patients enrolled and included in the analysis. Of 196 SM specimens, 9.7% (n = 19) had positive margins prior to excision of selective shave margins. Of these, 16 were identified by ISP with a sensitivity of 84%, specificity of 29%, false-negative rate (FNR) of 16%, positive predictive value (PPV) of 11%, and negative predictive value (NPV) of 95%. Surgeon assessment of DBT images identified 16/19 specimens with positive margins, with a sensitivity of 84% (p > 0.05), specificity of 49% (p < 0.001), FNR of 16% (> 0.05), PPV of 15% (p > 0.05), and NPV of 97% (p > 0.05). The median time for surgeon interpretation was 6 (range 2-35) minutes vs. 33 (range 15-88) for ISP.

conclusionsSurgeon interpretation of DBT images offers an alternative to a more time- and labor-intensive ISP for detecting positive margins during breast-conserving surgery, with comparable accuracy and higher sensitivity.

Indexed as

Breast NeoplasmsImaging, Three-DimensionalMammographyMargins of ExcisionMastectomy, SegmentalAdultAgedFemaleHumansMiddle AgedSurgeonsBreastIntraoperative tomosynthesis imagesMarginsSpecimenSurgeon interpretation

Identifiers

PMID42329454
PMCPMC13287223

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