Giovanna Romanucci1, Sara Mercogliano2, Elisabetta Carucci3, Alessandro Cina2, Elisa Zantedeschi4, Andrea Caneva5, Chiara Benassuti6, Francesca Fornasa6. 1. UOSD Breast Unit ULSS9 Scaligera, Fracastoro Hospital, 1 Via Circonvallazione, 37047, San Bonifacio, VR, Italy. giovanna.romanucci@aulss9.veneto.it. 2. Department of Diagnostic Imaging, Radiation Oncology and Haematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 3. Department of Diagnostic Imaging, Santa Maria Degli Angeli Hospital, Putignano, BA, Italy. 4. Department of Radiology, G. Fracastoro Hospital, San Bonifacio, VR, Italy. 5. Department of Anatomy and Pathological Histology, G. Fracastoro Hospital, San Bonifacio, VR, Italy. 6. Breast Unit ULSS9, G. Fracastoro Hospital, San Bonifacio, VR, Italy.
Abstract
OBJECTIVE: We investigated the accuracy of digital breast tomosynthesis compared to full-field digital mammography for evaluating tumor-free resection margins in the intraoperative specimen during breast-conserving surgery, reducing re-excision rates. MATERIALS AND METHODS: In total, 170 patients, with proven breast cancer and eligible for breast-conserving surgery, were enrolled. Intraoperative specimens underwent digital mammography and digital breast tomosynthesis. Two breast radiologists, with ten years of experience in breast imaging, in batch mode, evaluated tumor-free resection margins and the distance between the margins and lesion. Histopathological findings were considered the standard of reference. RESULTS: We used the correlation analysis to evaluate the agreement between measures of tumor-free resection margins obtained with digital mammography and the true value (histopathological findings), and between digital breast tomosynthesis and histopathological findings. The size evaluation determined by digital breast tomosynthesis was more accurately correlated with that found by pathology; the calculated Pearson's correlation coefficient of digital breast tomosynthesis and digital mammography to the pathologically determined tumor-free resection margins were 0.92 and 0.79 in CC view and 0.92 and 0.72 in LL view, respectively. Compared with the pathologically determined tumor-free resection margins, the size determined by both imaging modalities was, on average, overestimated. Bland-Altman analysis showed an excellent inter readers agreement. CONCLUSIONS: Digital breast tomosynthesis is more accurate in assessment of margin status than digital mammography; it could be a more accurate technique than full-field digital mammography for the intraoperative delineating of tumor resection margins.
OBJECTIVE: We investigated the accuracy of digital breast tomosynthesis compared to full-field digital mammography for evaluating tumor-free resection margins in the intraoperative specimen during breast-conserving surgery, reducing re-excision rates. MATERIALS AND METHODS: In total, 170 patients, with proven breast cancer and eligible for breast-conserving surgery, were enrolled. Intraoperative specimens underwent digital mammography and digital breast tomosynthesis. Two breast radiologists, with ten years of experience in breast imaging, in batch mode, evaluated tumor-free resection margins and the distance between the margins and lesion. Histopathological findings were considered the standard of reference. RESULTS: We used the correlation analysis to evaluate the agreement between measures of tumor-free resection margins obtained with digital mammography and the true value (histopathological findings), and between digital breast tomosynthesis and histopathological findings. The size evaluation determined by digital breast tomosynthesis was more accurately correlated with that found by pathology; the calculated Pearson's correlation coefficient of digital breast tomosynthesis and digital mammography to the pathologically determined tumor-free resection margins were 0.92 and 0.79 in CC view and 0.92 and 0.72 in LL view, respectively. Compared with the pathologically determined tumor-free resection margins, the size determined by both imaging modalities was, on average, overestimated. Bland-Altman analysis showed an excellent inter readers agreement. CONCLUSIONS: Digital breast tomosynthesis is more accurate in assessment of margin status than digital mammography; it could be a more accurate technique than full-field digital mammography for the intraoperative delineating of tumor resection margins.
Entities:
Keywords:
Breast-conserving surgery; Digital breast tomosynthesis; Digital mammography; Margin assessment; Specimen radiography
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