The Efficacy of Using Intraoperative Ultrasound and Frozen Pathology in Breast Conserving Surgery on Safe Surgical Boundary

Abidin Tüzün; Erkan Dalbaşı; Ercan Gedik

Makale detayları

The Efficacy of Using Intraoperative Ultrasound and Frozen Pathology in Breast Conserving Surgery on Safe Surgical Boundary

Yazarlar:

Abidin Tüzün | Erkan Dalbaşı | Ercan Gedik

Yayıncı:

Harran University

Ana Başlıklar:

Klinik Tıp Bilimleri

Dergi:

Harran Üniversitesi Tıp Fakültesi Dergisi Vol.20 Issue 2, pp.352-356

Belge Tipi:

Makale

Yayın Tarihi:

8/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001293779

pISSN:

1304-9623

Anahtar kelimeler:

Özet:

 Background: Breast cancer is the most common cancer in women over the age of 40. The lifetime risk is around 12. Today, breast cancer patients are diagnosed at an early stage thanks to screening programs, and thus mortality has decreased to around 25-30. The positivity or closeness of surgical margins in breast conserving surgery varies between 5-60. Negativity of surgical margins is very important to prevent future recurrent breast cancer, to pre-vent recurrent surgeries, and to prevent additional treatments. In this study, we aimed to investigate the efficacy of intraoperative ultrasonography and frozen section use in breast cancers treated with breast conserving surgery in obtaining safe surgical margins and in postoperative cosmetic terms. Materials and Methods: This study includes 150 patients diagnosed with breast cancer and treated with breast con-serving surgery in between January 2015 and January 2019. The presence of distant metastases and multifocal or centrally located tumor involvement in the breasts were investigated. The localization of the tumor was marked anatomically by preoperative ultrasonography in all patients. The operation was started 15 minutes after the injec-tion. The tumor was completely excised, leaving at least 1 cm of intact tissue around the tumor, including the skin, on the preoperatively marked area, including the underlying muscle fascia. Medial and superior borders were marked with string. This excised tissue block was examined with intraoperative ultrasonography. Results: The mean age of the patients was 48,3 9.7 years. While the tumor was located in the right breast in 83 55.3 of the patients, it was located in the left breast in 67 44.7 patients. The tumor was located in the upper outer quadrant in 67 44.7 patients, in the upper inner quadrant in 53 35.3 patients, and in the lower outer quadrant in 30 20 patients. Axillary dissection was performed in 21 14  of the patients because sentinel lymph node was positive. In histological typing, 141 94  patients were ductal carcinoma and 9 6  patients were lobular carcinoma. Conclusions: As a result of our study and literature review, we think that frozen examination together with intraope-rative ultrasonography is a simple, easily applicable and cosmetically good method to determine the safe surgical margin in breast conserving surgery.

 Background: Breast cancer is the most common cancer in women over the age of 40. The lifetime risk is around 12. Today, breast cancer patients are diagnosed at an early stage thanks to screening programs, and thus mortality has decreased to around 25-30. The positivity or closeness of surgical margins in breast conserving surgery varies between 5-60. Negativity of surgical margins is very important to prevent future recurrent breast cancer, to pre-vent recurrent surgeries, and to prevent additional treatments. In this study, we aimed to investigate the efficacy of intraoperative ultrasonography and frozen section use in breast cancers treated with breast conserving surgery in obtaining safe surgical margins and in postoperative cosmetic terms. Materials and Methods: This study includes 150 patients diagnosed with breast cancer and treated with breast con-serving surgery in between January 2015 and January 2019. The presence of distant metastases and multifocal or centrally located tumor involvement in the breasts were investigated. The localization of the tumor was marked anatomically by preoperative ultrasonography in all patients. The operation was started 15 minutes after the injec-tion. The tumor was completely excised, leaving at least 1 cm of intact tissue around the tumor, including the skin, on the preoperatively marked area, including the underlying muscle fascia. Medial and superior borders were marked with string. This excised tissue block was examined with intraoperative ultrasonography. Results: The mean age of the patients was 48,3 9.7 years. While the tumor was located in the right breast in 83 55.3 of the patients, it was located in the left breast in 67 44.7 patients. The tumor was located in the upper outer quadrant in 67 44.7 patients, in the upper inner quadrant in 53 35.3 patients, and in the lower outer quadrant in 30 20 patients. Axillary dissection was performed in 21 14  of the patients because sentinel lymph node was positive. In histological typing, 141 94  patients were ductal carcinoma and 9 6  patients were lobular carcinoma. Conclusions: As a result of our study and literature review, we think that frozen examination together with intraope-rative ultrasonography is a simple, easily applicable and cosmetically good method to determine the safe surgical margin in breast conserving surgery.

 Background: Breast cancer is the most common cancer in women over the age of 40. The lifetime risk is around 12. Today, breast cancer patients are diagnosed at an early stage thanks to screening programs, and thus mortality has decreased to around 25-30. The positivity or closeness of surgical margins in breast conserving surgery varies between 5-60. Negativity of surgical margins is very important to prevent future recurrent breast cancer, to pre-vent recurrent surgeries, and to prevent additional treatments. In this study, we aimed to investigate the efficacy of intraoperative ultrasonography and frozen section use in breast cancers treated with breast conserving surgery in obtaining safe surgical margins and in postoperative cosmetic terms. Materials and Methods: This study includes 150 patients diagnosed with breast cancer and treated with breast con-serving surgery in between January 2015 and January 2019. The presence of distant metastases and multifocal or centrally located tumor involvement in the breasts were investigated. The localization of the tumor was marked anatomically by preoperative ultrasonography in all patients. The operation was started 15 minutes after the injec-tion. The tumor was completely excised, leaving at least 1 cm of intact tissue around the tumor, including the skin, on the preoperatively marked area, including the underlying muscle fascia. Medial and superior borders were marked with string. This excised tissue block was examined with intraoperative ultrasonography. Results: The mean age of the patients was 48,3 9.7 years. While the tumor was located in the right breast in 83 55.3 of the patients, it was located in the left breast in 67 44.7 patients. The tumor was located in the upper outer quadrant in 67 44.7 patients, in the upper inner quadrant in 53 35.3 patients, and in the lower outer quadrant in 30 20 patients. Axillary dissection was performed in 21 14  of the patients because sentinel lymph node was positive. In histological typing, 141 94  patients were ductal carcinoma and 9 6  patients were lobular carcinoma. Conclusions: As a result of our study and literature review, we think that frozen examination together with intraope-rative ultrasonography is a simple, easily applicable and cosmetically good method to determine the safe surgical margin in breast conserving surgery.

 Amaç: Meme kanseri 40 yaş üstü kadınlarda en sık görülen kanserdir. Yaşam boyu risk 12 civarındadır. Günümüzde tarama programları sayesinde meme kanseri hastalarına erken tanı konulmakta ve bu sayede ölüm oranları 25-30 civarına düşmektedir. Meme Koruyucu Cerrahide cerrahi sınırların pozitifliği veya yakınlığı 5-60 arasında değişmektedir. İleride tekrar meme kanseri oluşmasını önlemek, tekrarlayan ameliyatları önlemek ve ek tedavilerin önüne geçmek için cerrahi sınırların negatifliği çok önemlidir. Bu çalışmada Meme Koruyucu Cerrahi ile tedavi edilen meme kanserlerinde intraoperatif ultrasonografi ve frozen kesit kullanımının güvenli cerrahi sınır elde etmede ve postoperatif kozmetik açıdan etkinliğini araştırmayı amaçladık. Materyal ve Metod: Bu çalışma, Ocak 2015 ile Ocak 2019 tarihleri arasında meme kanseri tanısı alan ve Meme Koruyucu Cerrahi ile tedavi edilen 150 hastayı içermektedir. Memelerde uzak metastaz varlığı ve multifokal ya da santral yerleşimli tümör tutulumu araştırıldı. Tüm hastalarda tümörün lokalizasyonu preoperatif ultrasonografi ile anatomik olarak işaretlendi. Tümör tamamen eksize edildi ve altta yatan kas fasyası da dahil olmak üzere ameliyat öncesi işaretli alanda deri de dahil olmak üzere tümörün çevresinde en az 1 cm sağlam doku bırakıldı. Medial ve superior sınırlar ip ile işaretlendi. Eksize edilen bu doku bloğu intraoperatif ultrasonografi ile incelendi. Bulgular: Hastaların yaş ortalaması 48,3 9,7 idi. Tümör hastaların 83 55,3ünde sağ memede yerleşirken, 67 44,7 hastada sol memede yerleşmişti. Tümör 67 44,7 hastada üst dış kadranda, 53 35,3 hastada üst iç kadranda, 30 20 hastada alt dış kadranda yerleşmişti. Hastaların 21ine 14 sentinel lenf nodu pozitifliği nedeniyle aksiller diseksiyon uygulandı. Histolojik tiplendirmede 141 94 hasta duktal karsinom ve 9 6 hasta lobüler karsinomdu. Sonuç: Çalışmamız ve literatür taraması sonucunda intraoperatif ultrasonografi ile birlikte frozen incelemenin Meme Koruyucu Cerrahide güvenli cerrahi sınırı belirlemede basit, kolay uygulanabilir ve kozmetik açıdan iyi bir yöntem olduğunu düşünüyoruz.

Makale detayları

The Efficacy of Using Intraoperative Ultrasound and Frozen Pathology in Breast Conserving Surgery on Safe Surgical Boundary

Yazarlar:

Abidin Tüzün | Erkan Dalbaşı | Ercan Gedik

Yayıncı:

Harran University

Ana Başlıklar:

Klinik Tıp Bilimleri

Dergi:

Harran Üniversitesi Tıp Fakültesi Dergisi Vol.20 Issue 2, pp.352-356

Belge Tipi:

Makale

Yayın Tarihi:

8/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001293779

pISSN:

1304-9623

breast cancer

ultrasonography

surgical margin

frozenmeme kanseri

ultrasonografi

cerrahi sınır

frozen

Sayı

Makale detayları

Yazarlar: Abidin Tüzün | Erkan Dalbaşı | Ercan Gedik

Yayıncı: Harran University

Ana Başlıklar: Klinik Tıp Bilimleri

Dergi: Harran Üniversitesi Tıp Fakültesi Dergisi Vol.20 Issue 2, pp.352-356

Belge Tipi: Makale

Yayın Tarihi: 8/2023

Belge Dili: İngilizce

Document ID (Org No.): 2001293779

pISSN: 1304-9623

Sayı

Yazarlar:

Abidin Tüzün | Erkan Dalbaşı | Ercan Gedik

Yayıncı:

Harran University

Ana Başlıklar:

Klinik Tıp Bilimleri

Dergi:

Harran Üniversitesi Tıp Fakültesi Dergisi Vol.20 Issue 2, pp.352-356

Belge Tipi:

Makale

Yayın Tarihi:

8/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001293779

pISSN:

1304-9623