Intraoperative ultrasound is associated with clear lumpectomy margins for palpable infiltrating ductal breast cancer.

OBJECTIVE: To evaluate the efficacy of intraoperative ultrasound in obtaining adequate surgical margins in women undergoing lumpectomy for palpable breast cancer.

SUMMARY BACKGROUND DATA: Adequacy of surgical margins is a subject of debate in the literature for women undergoing breast-conserving therapy. The emerging technology of intraoperative ultrasound-guided surgery lends itself well to a prospective study evaluating surgical accuracy and margin status after lumpectomy.

METHODS: Two groups of women undergoing lumpectomy for palpable breast cancer were studied, one group using intraoperative ultrasound (n = 27) and the other without (n = 24). Pathologic specimens were evaluated for size, margins, and accuracy, and patients were questioned about satisfaction with cosmetic results.

RESULTS: Surgical accuracy was improved with intraoperative ultrasound-guided surgery. Margin status was improved, patient satisfaction was equivalent, and cost was not affected using ultrasound technology. Intraoperative ultrasound appears especially efficacious for women whose preoperative mammogram shows dense parenchyma surrounding the lesion.

CONCLUSIONS: The use of ultrasound-guided surgery optimizes the surgeon's ability to obtain satisfactory margins for breast-conserving techniques in patients with breast cancer. Patient satisfaction is excellent and a cost savings is most likely realized.