View for View, 3D Specimen Tomosynthesis Provides More Data Than 2D Specimen Mammography

Kaufman C, Zacharias K, Rogers A, Nix S, ODonnell J, Ness K, Schnell N, Hill L

Poster presented at: American Society of Breast Surgeons; 2017 May 2-5; Las Vegas, NV.

  • Over an 18-month period, 200 patients who had image guided lumpectomies using both intraoperative 2D imaging and intraoperative 3D tomosynthesis were compared
  • During the 18 months of adoption of the intraoperative 3D tomosynthesis, there was a significant reduction in re-excision rates, from 16% to 9%
  • Use of specimen tomosynthesis in the OR has improved the accurate of intraoperative imagining in 43% of cases

Differences in Re-excisions Rates for Breast Conserving Surgery using Intraoperative 2D vs. 3D Tomosynthesis Specimen Radiograph

Colton A, Calvo C, Mokdad A, Pouns K, Clifford E, Farr D, Huth J, Wooldridge R, Leitch M, Partain N.

Poster presented at: American Society of Breast Surgeons; 2019 May 1-4; Dallas, TX.

  • 514 breast conserving operations for cancer were performed from 2016-2018
  • 323 cases performed using 2D while 191 cases performed using 3D
  • A lower re-excision rate (50% reduction) is independently associated with 3D tomosynthesis
  • 3D tomosynthesis may be considered
    to reduce re-operation rates by allowing surgeons to excise additional margins at the index operation, decreasing reoperations and anxiety/costs for patients

Implementation of Intra-Operative Specimen Tomosynthesis and Impact of Re-Excision Rates for Image Guided Partial Mastectomies

Munding E, Woodfin A, Terranella S, O’Donoghue C, O’Hara K, Madrigrano A

  • Use of MOZART for localization versus remote radiologic interpretation for determining additional shave margins is associated with lower positive margins rates.
  • Use of MOZART was shown to discover positive margins that would have been missed based on final pathology of initial specimen alone.

The temporal and financial benefit of intraoperative breast specimen imaging: A pilot study of the Kubtec MOZART

Kornfeld H, Mulder L, Spivey T, Cortina C, Madrigrano A, Kopkash K. Breast J. 2019;25:766-768.

  • A retrospective chart review was conducted of all breast cancer patients from Jan 1, 2015 to December 31, 2016 with non-palpable lesions requiring wire- localization for excision
  • On average, OR time was 7.6 minutes shorter when using intraoperative imaging as opposed to sending the specimen to diagnostic radiology. This time reduction translates into estimated OR cost savings of $284.62 per case
  • This three-dimensional intraoperative imaging allows the surgeon to make a more accurate decision regarding targeted shave margins, which may improve more aesthetics and decrease re-excision rate, which would also provide a financial benefit

Digital Breast Tomosynthesis for Intraoperative Margin Assessment during Breast-Conserving Surgery

Park KU, Kuerer HM, Rauch GM, Leung JWT, Sahin AA, Wei W, Li Y, Black DM.

Ann Surg Oncol 2019:26:1720-28.

  • Study was to determine the ability of digital breast tomosynthesis (DBT) to detect positive margins compared with an institution’s standard extensive processing (SEP)
  • This demonstrated the ability of DBT to accurately identify segmental mastectomy specimens having tumor at ink, with a similar sensitivity and higher specificity compared with our institutional SEP
  • DBT can replace labor-intensive processing methods given that its rapid acquisition of high resolution, cross-sectioned images of the intact specimen takes approximately 1 min, and can be read by the surgeon