[Identification of surgical margins by intraoperative mammography of quadrantectomys specimens for breast cancer and histopathological comparison]

Abstract

Background: Wide surgical margins are prognostic indicators to prevent recurrences after conservative surgery in breast cancer; type of surgery and histopathological analysis are key factors too.

Objectives: To evaluate tumoral size and surgical margins of quadrantectomy specimens utilizing mammography and histopathology, and decide if mammography of quadrantectomy specimens are useful for close margins prediction.

Materials and methods: Prospective, observational and descriptive study based on the findings of specimen projections of two mammography quadrantectomies, and histopathological data. Ten patients with breast cancer were evaluated from May to November 2006. Surgical margins of quadrantectomys were marked with radiopaque material.

Results: Tumoral size was similar in mammography and histopathological analysis of quadrantectomys, however there was a tendency to report a larger size in mammography. With mammography only one case was reported as close superficial margin, the rest of patients has adequate margins (1 cm or higer). Five cases were close by histopathology (3 in the deep margin, one superior and one more in the superior and inferior margins), and five had adequate margins. Four additional surgical procedures where practiced (3 re-excisions and one mastectomy), in one of them additional surgery was unnecessary.

Conclusions: Mammography evaluation was useful to identify peripheral margins (superior, inferior medial and lateral) as well as tumoral size, but useless to identify close borders (deep and superficial areas). It is necessary to evaluate more cases to improve this technique and to establish a common language between specialists.