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Technology for Intraoperative Margin Assessment in Breast Cancer

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

A Correction to this article was published on 13 May 2020

This article has been updated

Abstract

Background

As breast-conserving surgery (BCS) has become standard for treatment of breast cancer, the need for new technology to improve intraoperative margin assessment (IMA) has become clear. Close or positive margins during BCS lead to additional surgeries, treatment delay, additional stress for patients, and healthcare cost. Academia and industry have developed a diverse field of new technologies to allow surgeons to assess margins in the operating room. These technologies aim to reduce current rates of positive margins on final pathology.

Methods

We selected recently developed IMA technologies, some of which have undergone large clinical trials and others that are still in early stage development. Technologies were categorized based on underlying methodology to differentiate malignant and normal tissue: spectroscopy, electrical properties, optical imaging and molecular imaging. Additionally, this review details clinical investigations, relevant statistical analysis as well as strengths and weaknesses of the various technologies.

Conclusion

Numerous technical innovations are being implemented to diminish rates of positive margins at breast tumor resection. Close collaboration among cross-disciplinary teams to further develop many of these technologies as well as completion of larger scale clinical studies are required to define an optimal approach. Development with an eye toward prioritizing sensitivity/specificity as well as healthcare cost containment has the potential to make a significant impact on this ongoing clinical need in breast cancer surgery.

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Fig. 1

Change history

  • 13 May 2020

    In the original version of the article, some of the entries in Table��1 shifted during typesetting. The publisher regrets the error. The original article has been corrected. Following is the corrected table.

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Acknowledgements

We thank Dr Brett Miles for critical review of the manuscript.

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Authors and Affiliations

  1. Dubin Breast Center, Tisch Cancer Institute, New York, USA

    Julia Schwarz BA & Hank Schmidt MD, PhD

  2. Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Julia Schwarz BA & Hank Schmidt MD, PhD

  3. Breast Surgical Oncology, The Mount Sinai Hospital, New York, NY, USA

    Julia Schwarz BA & Hank Schmidt MD, PhD

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  1. Julia Schwarz BA
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Correspondence to Hank Schmidt MD, PhD.

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Dr. Schmidt has received material support from Perimeter Medical Imaging.

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The original version of the article has been revised: In the original version of the article, some of the entries in Table 1 shifted during typesetting. The publisher regrets the error.

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Schwarz, J., Schmidt, H. Technology for Intraoperative Margin Assessment in Breast Cancer. Ann Surg Oncol 27, 2278–2287 (2020). https://doi.org/10.1245/s10434-020-08483-w

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