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Sonographic Hematoma Guided Versus Wire Localized Lumpectomy for Breast Cancer: A comparison of Margins and Volume of Resection
Rakhshanda Layeeque, Elaine Iuanow, Sybil Crawford, Robert M Quinlan
U Mass Memorial Health Center, Worcester, MA
Objective: To compute the differences in margin clearance and volume of resection between Sonographic Hematoma guided (SHG) and wire localized (WL) lumpectomy for non-palpable breast cancers visualized on mammograms but not on ultrasound.
Design: Retrospective study.
Setting: University Comprehensive Breast Center
Patients: Consecutive patients treated at the breast center with stereotactic biopsy proven cancers that were not visualized on ultrasound, over a period of 6 months. SHG and WL technique were compared.
Main Outcome Measures: Matching variables - Age, mammographic abnormality, tumor size and type, and lymph node status. Outcome variables - Closest margin of resection, volume of resection, resection index (resection volume/tumor volume), and rate of margin revision.
Results: Twenty-nine patients had SHG while 34 had WL lumpectomy. The SHG and WL groups were similar in age, mammogramphic abnormality, tumor size, type and lymph node status. Median (25th-75th centile) closest margin in SHG vs. WL group was 5.0 (5.0-8.0) vs 3.5 (1.0-7.0) mm [p=0.0114]. Median (25th-75th centile) resection volume in SHG vs. WL group was 85.0 (60.0-128.0) vs. 143.4 (54.4-229.0) cm3 [p=0.0483]. Median resection index in SHG vs. WL group was 77.1 (51.4-220.0) vs. 315.9 (188.9-3025.0) [p=0.003]. Margin was revised in 1 (3.45%) of the SHG vs. 5 (14.7%) WL lumpectomy patients [p=0.2.0]
Conclusions: Sonographic Hematoma guided lumpectomy is superior to wire localization in obtaining adequate margins while minimizing the volume of resection.
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