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Review
. 2023 Jun;14(16):1413-1419.
doi: 10.1111/1759-7714.14890. Epub 2023 Apr 18.

Evaluating the impact of radiofrequency spectroscopy on reducing reoperations after breast conserving surgery: A meta-analysis

Jingzhen Wang  1 , Lixia Zhang  2 , Zezheng Pan  3
Affiliations
Review

Evaluating the impact of radiofrequency spectroscopy on reducing reoperations after breast conserving surgery: A meta-analysis

Jingzhen Wang et al. Thorac Cancer. 2023 Jun.

Abstract

Background: The benefits of breast conserving surgery for breast cancer patients are well established. To achieve adequate margins of excision, intraoperative management of breast margins is a critical factor through reducing reoperation for inadequate positive margin excision and associated morbidity and cost. Radiofrequency spectroscopy is a technology that could significantly reduce positive margins when used intraoperatively as an adjunct to other margin management methods.

Methods: A meta-analysis was completed with 10 publications comparing use of radiofrequency spectroscopy technology (MarginProbe) with standard margin assessment procedures. Three randomized controlled studies and seven retrospective studies comparing MarginProbe to historical controls were included. The primary endpoint was reduction of re-excision rates. Statistical significance level was set at the two-sided 5% level corresponding to two-sided 95% confidence intervals (CIs) of the pooled relative risk estimates.

Results: A total of 2335 patients from 10 publications were included in this meta-analysis. The overall relative reduction in re-excision rate was 0.49 (95% CI: 0.38-0.64, p < 0.001). Statistical methods were used to examine publication bias.

Conclusion: Despite the limited randomized controlled trials available comparing radiofrequency spectroscopy to standard operation procedures, the data from the 10 studies demonstrate a statistically significant reduction in re-excision rate of 49% for MarginProbe usage, currently the only technology indicated for intraoperative identification of breast cancer tissue at the lumpectomy specimen margin.

Keywords: MarginProbe; breast cancer; breast conserving surgery; meta-analysis; re-excision.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Publication selection flow chart following the PRISMA guideline.
FIGURE 2
FIGURE 2
Forest plot results of all 10 studies used in meta‐analysis. Each black square represents the relative risk of having re‐excision, as calculated for each study and listed in the column “Relative Risk” on the right.The horizontal lines to the left and right of each square represent the lower and upper confidence limits, and the actual values are listed on the right. The pooled risk ratio is represented in the bottom row with black diamond. The left and right points of the diamond indicate the confidence limits.
FIGURE 3
FIGURE 3
Funnel plot results of all 10 studies used in meta‐analysis. Each dot represents a study. The y‐axis is the standard error of the effect estimate. Larger studies with higher power are placed towards the top. Lower powered studies are placed towards the bottom. The x‐axis shows the risk ratio for the study. The plot should ideally resemble a pyramid funnel, with scatter due to sampling variation. The shape is expected because the studies have a wide range of standard errors.
See this image and copyright information in PMC

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