‍‍Dr. Ralph L. Corsetti shares two cases where he utilized 3D tomosynthesis technology intraoperatively to aid during the patient’s surgeries. Dr. Corsetti shares the medical history and patient's physicals, along with what the patient opted for during surgery and the results from final pathology.

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‍"It allows for real time, immediate analysis of the gross margin and for intra-operative re-excision which may obviate the need for a second surgery.”  -Dr. Ralph L. Corsetti MD, FACS

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Case Study – 1

• 76years old women with a 1.9 cm irregular, speculated mass in the UOQ (Upper Outer Quadrant) 2 o’clock position of the left breast on screening and diagnostic imaging
• CNB revealed at least high-grade DCIS, solid type with central necrosis
• ER positive, PR negative
• Medical History – HTN, asthma
• Family History - Breast CA in her mother at age 60
• GYN History – Menarche 14, Menopause 52, G2P2 w/ first live birth at 27
• No history of HRT
• ROS– Negative
• Genetic testing – Negative
• BCBE WNL – No masses, skin changes, or LAD‍

Case Study – 2

• 61years old women with a personal history of breast cancer
• History of “DCIS” in UOQ of right breast in 2003, treated with lumpectomy only at MSKCC
• No adjuvant radiotherapy nor endocrine therapy
• s/p bilateral breast reduction & lift (mastoplasty/mastopexy) in 2006
• Diagnostic Mammogram in 2021 revealed a 5mm area of grouped, linear, pleomorphic calcifications, BI-RADS 4, in vicinity of prior lumpectomy, posterior- middle depth
• Personal History – Ovarian CA 2001 at 41; DCIS R breast 2003 at age 43; hypothyroidism(on Synthroid)
• Family History – PGM w/DCIS at 80; sister w/DCIS in her 50’s
• Genetic testing – Negative; Updated 2016: negative
• GYN History – Menarche 15; Menopause surgically at 41 with TAH/BSO, G4P4 with first child at age 24
• HRT for two years: 2001-2003 (discontinued at time of DCIS Dx)
• BCBE WNL – No masses, skin changes, or LAD‍

Discussion

• How KUBTEC's Mozart system allows for real time immediate analysis of the gross margin
• 3D tomosynthesis benefits to patients and hospital systems (patient satisfaction and costs)
• How 3D Tomosynthesis evaluation improves accuracy
• Allows for intra-operative re-excision which may obviate the need for a second surgery

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Surgeon Biography:

Dr. Corsetti is a Professor of Surgery at the Tulane University School of Medicine within the Department of Surgery with a clinical practice in surgical oncology including breast, endocrine, and melanoma surgery at Tulane's Northshore campus based at Lakeview Regional Medical Center in Covington, LA. Dr. Corsetti received his Bachelor of Arts degree graduating Magna Cum Laude from Boston University in 1987.

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