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Annals of Surgical Oncology

, Volume 21, Issue 10, pp 3356–3357 | Cite as

Pilot Study to Evaluate Feasibility of Image-Guided Breast-Conserving Therapy in the Advanced Multimodal Image-Guided Operating (AMIGO) Suite

  • Mehra GolshanEmail author
  • Yasuaki Sagara
  • Barbara Wexelman
  • Fatih Aydogan
  • Stephen Desantis
  • H. Elise Min
  • Kirby Vosburgh
  • Jayender Jagadeesan
  • Diana Caragacianu
  • Eva Gombos
  • Ferenc Andras Jolesz
Original Article – Breast Oncology

Abstract

Background

The rate of reexcision in breast-conserving surgery remains high, leading to delay in initiation of adjuvant therapy, increased cost, increased complications, and negative psychological impact to the patient.1 3 We initiated a phase 1 clinical trial to determine the feasibility of the use of intraoperative magnetic resonance imaging (MRI) to assess margins in the advanced multimodal image-guided operating (AMIGO) suite.

Methods

All patients received contrast-enhanced three-dimensional MRI while under general anesthesia in the supine position, followed by standard BCT with or without wire guidance and sentinel node biopsy. Additional margin reexcision was performed of suspicious margins and correlated to final pathology (Fig. 1). Feasibility was assessed via two components: demonstration of safety and sterility and acceptable duration of the operation and imaging; and adequacy of intraoperative MRI imaging for interpretation and its comparison to final pathology.
Fig. 1

Schema of AMIGO trial

Results

Eight patients (mean age 48.5 years), 4 with stage I breast cancer and 4 with stage II breast cancer, were recruited. All patients underwent successful BCT in the AMIGO suite with no AMIGO-specific complications or break in sterility during surgery. The mean operative time was 113 min (range 93–146 min).

Conclusions

Our experience with AMIGO suggests that it is feasible to use intraoperative MRI imaging to evaluate margin assessment in real time. Further research is required to identify modalities that will lead to a reduction in reexcision in breast cancer therapy.

Keywords

Breast Cancer Magnetic Resonance Imaging Oncol Gadolinium Supine Position 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

The authors declare that they have no conflict of interest.

Supplementary material

Supplementary material 1 (MP4 234748 kb)

References

  1. 1.
    Heil J, Breitkreuz K, Golatta M, et al. Do reexcisions impair aesthetic outcome in breast conservation surgery? Exploratory analysis of a prospective cohort study. Ann Surg Oncol. 2012;19: 541–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Russo AL, Arvold ND, Niemierko A, et al. Margin status and the risk of local recurrence in patients with early-stage breast cancer treated with breast-conserving therapy. Breast Cancer Res Treat. 2013;140:353–61.PubMedCrossRefGoogle Scholar
  3. 3.
    Waljee JF, Hu ES, Newman LA, Alderman AK. Predictors of re-excision among women undergoing breast-conserving surgery for cancer. Ann Surg Oncol. 2008;15:1297–303.PubMedCrossRefGoogle Scholar

Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Mehra Golshan
    • 1
    Email author
  • Yasuaki Sagara
    • 1
  • Barbara Wexelman
    • 1
  • Fatih Aydogan
    • 1
    • 2
  • Stephen Desantis
    • 3
  • H. Elise Min
    • 1
  • Kirby Vosburgh
    • 4
  • Jayender Jagadeesan
    • 4
  • Diana Caragacianu
    • 1
  • Eva Gombos
    • 4
  • Ferenc Andras Jolesz
    • 4
  1. 1.Department of SurgeryBrigham and Women’s Hospital and Dana-Farber Cancer InstituteBostonUSA
  2. 2.Department of Breast Surgery, Cerrahpasa Medical SchoolIstanbul UniversityIstanbulTurkey
  3. 3.Breast Oncology CenterDana Farber Cancer InstituteBostonUSA
  4. 4.Department of RadiologyBrigham and Women’s HospitalBostonUSA

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