[Specimen radiography assessment of surgical margins status in subclinical breast carcinoma: a diagnostic study]. / Évaluation radiographique du statut des marges de résection dans le carcinome in situ du sein: une étude diagnostique.
J Gynecol Obstet Biol Reprod (Paris)
; 40(4): 314-22, 2011 Jun.
Article
en Fr
| MEDLINE
| ID: mdl-21349659
OBJECTIVE: This study aimed to determine the accuracy of specimen radiography in evaluating the surgical margins of impalpable breast carcinoma. DESIGN AND SETTING: Retrospective study from June 2009 to June 2010 in Orleans Hospital Center. PATIENTS AND METHODS: The study involved patients with impalpable in situ breast carcinoma diagnosed by mammography. Only patients with larger in situ carcinoma than invasive carcinoma were included. Patients underwent a breast conserving surgery after preoperative localization of the lesion. PRIMARY ENDPOINT: Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the specimen radiography are determined by correlation between radiologic and histologic margins. RESULTS AND DISCUSSION: The following results were obtained from 46 patients: 36 DCIS cases (78%), six DCIS with IDC cases (13%), two LCIS cases (4%) and two biopsy suggested DCIS (4%). A radiologic margin of 2mm (by analogy with the histological margins) results in a NPV of 73%. NPV, sensibility and specificity were respectively 79, 60 and 74% for a radiologic margin of 5mm. The measure or inter-rater reliability found a moderate agreement (kappa: 0.62). The systematic review on this topic found only eight articles (small samples and only two prospective studies). We could not make any recommendations from the literature review on a threshold to define excision margin status. CONCLUSION: The specimen radiography is a useful tool to assess margins of impalpable breast carcinoma. However, further studies are necessary as this point to determine a threshold for those radiologic margins.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias de la Mama
Tipo de estudio:
Diagnostic_studies
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Guideline
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
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Systematic_reviews
Límite:
Adult
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Aged
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Female
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Humans
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Middle aged
Idioma:
Fr
Revista:
J Gynecol Obstet Biol Reprod (Paris)
Año:
2011
Tipo del documento:
Article
País de afiliación:
Francia
Pais de publicación:
Francia