Ultrasound-Guided Breast-Conserving Surgery May Reduce Need for Further SurgeriesUsing ultrasound to guide the surgical removal of tumors from women with palpable breast cancer is significantly better than the standard approach in ensuring that all cancerous tissue is removed while minimizing the removal of healthy tissue, a new study shows. The results, from a Dutch randomized, controlled clinical trial, were presented March 23 at the Eighth European Breast Cancer Conference , in Vienna, Austria.
If confirmed in other trials, the ultrasound-guided approach could become standard practice.
“Breast-conserving surgery for palpable breast cancer is generally performed with guidance from [the] surgeon’s palpation only,” lead investigator Dr. Nicole Krekel of VU University Medical Center in Amsterdam said in a news release. Unfortunately, she noted, the standard approach “is associated with a high rate of margins that contain cancer cells, as well as the excision of excessively large volumes of tissue.” If a pathologist finds that tumor cells are still present at the site of surgery, additional surgery is usually needed to eliminate cancerous tissue and reduce the risk of local recurrence.
Dr. Krekel and her colleagues randomly assigned 124 patients with palpable early-stage breast cancer to either ultrasound-guided surgery or palpation-guided surgery. They found that only 3.3 percent of the margins in the ultrasound-guided surgery group contained cancer cells, compared with 16.4 percent in the palpation-guided surgery group. They also found that less healthy tissue was removed in the ultrasound-guided surgery group.
Using ultrasound enables surgeons to see all around the tumor during surgery and to position the incision on the breast optimally, Dr. Krekel explained.
“If we get the same results in the United States, and these results can be incorporated into community practice, it will spare many women unnecessary re-excision surgery,” said Dr. Jo Anne Zujewski, head of Breast Cancer Therapeutics in NCI’s Division of Cancer Treatment and Diagnosis.
See also: “Additional Surgery after Breast-Conserving Surgery Varies Widely”