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Automated breast ultrasound (ABUS) for intraoperative margin control on surgical specimens in breast conserving surgery

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

As breast-conserving surgery (BCS) has become the standard for treatment of early breast cancer, the need for new technologies to improve intraoperative margin assessment has become clear. Close or positive margins during BCS lead to additional surgeries, treatment delay, additional stress for patients and increasing healthcare cost. Automated three-dimensional breast ultrasound (ABUS) systems are meant to overcome the shortcomings of hand-held ultrasound (HHUS). In this study, we investigate the feasibility of ABUS to conduct ultrasound on surgical specimens in breast conserving therapy.

Methods

In this monocentric, non-interventional study, specimens of 40 women were examined via ABUS. A construction with isotonic saline solution, gel pads and ABUS membranes was invented by our team to produce images of breast cancer specimens using ABUS. Evaluation of the ABUS images was carried out by two independent physicians trained on ABUS evaluation.

Results

ABUS was conducted on 40 specimens. 90% of the generated images were of high quality. Measured tumor sizes with ABUS were bigger than measured tumor size with HHUS (mean tumor size 22.9 vs. 18.1 mm, CI 2.38–7.35, p < 0.05). The mean difference between the ABUS tumor size and the pathological tumor size was 1.8 mm (CI − 0.84–4.53, p = 0.17). The mean difference between the HHUS tumor size and the pathological tumor size was 3.2 mm (CI − 5.35 to − 1.03, p = 0.005).

Conclusion

ABUS seems to be a suitable method to conduct specimen ultrasound. Further studies are required to evaluate the accuracy of ABUS for intraoperative margin assessment and possible implementation in clinical work routine.

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Data availability

The data that support the findings of this study are available from the corresponding author (MEH).

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Gynecology and Obstetrics, University Medical Centre Regensburg, Landshuterstrasse 65, 93053, Regensburg, Germany

    Maria Eleni Hatzipanagiotou, Deborah Huber, Elisa Thede, Miriam Fernandez-Pacheco, Madeleine Hetterich, Blanca Roca Ripoll, Olaf Ortmann & Stephan Seitz

  2. Department of Pathology, University Medical Centre Regensburg, 93053, Regensburg, Germany

    Alexander Scheiter

Authors
  1. Maria Eleni Hatzipanagiotou
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  2. Deborah Huber
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  3. Elisa Thede
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  4. Alexander Scheiter
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  5. Miriam Fernandez-Pacheco
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  6. Madeleine Hetterich
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  7. Blanca Roca Ripoll
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  8. Olaf Ortmann
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  9. Stephan Seitz
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Contributions

MEH: protocol development, data collection and management, data analysis, and manuscript writing. DH: data collection, data analysis, and manuscript editing. ET: data management and data analysis. AS: pathological analysis. MF-P: data collection. MH: data collection. BRR: data collection. OO: manuscript editing and supervision. SS: protocol development, manuscript editing, and supervision.

Corresponding author

Correspondence to Maria Eleni Hatzipanagiotou.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

This study was carried out in accordance with The Code of Ethics of the World Medical Association (Declaration of Helsinki). The study was registered by the local ethical committee (Reference no. 21-2309-104).

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Hatzipanagiotou, M.E., Huber, D., Thede, E. et al. Automated breast ultrasound (ABUS) for intraoperative margin control on surgical specimens in breast conserving surgery. Arch Gynecol Obstet 307, 1949–1955 (2023). https://doi.org/10.1007/s00404-022-06837-1

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  • DOI: https://doi.org/10.1007/s00404-022-06837-1

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