Intraoperative ultrasound is an effective and preferable technique to localize non-palpable breast tumors

Abstract 

Introduction

Non-palpable breast tumors represent an increasing management problem in modern Breast Units. Therefore, a simple and accurate procedure to localize these lesions is needed. To date, the most commonly used technique is wire localization, but there are some disadvantages.

Methods

We conducted a prospective study on patients with malignant or benign non-palpable breast tumors who were surgically treated and underwent intraoperative ultrasound (IOUS) from May 2006 to June 2007. Margins of excision were inked and specifically assessed by the pathologist, and were considered positive if ≤1 mm.

Results

There were 77 patients (60 malignant and 17 benign lesions), with a median age of 54 years (36–87), and a median diameter of 9mm (4–17). All lesions were correctly identified and localized by IOUS, and free margins of excision were obtained in 75/77 cases (97%). Only two patients required a re-excision, one for multifocal disease and one for margins of excision of 1mm. In the remaining cases, the median distance from the tumor to the closest margins of excision, with exclusion of the posterior (fascial) and anterior (skin) margins, was 1.3cm (0.3–3.2).

Conclusions

IOUS is a simple and accurate procedure that can be used to identify most non-palpable breast tumors, and has many advantages over the more commonly used wire-localization technique.

Keywords: Breast cancer, Ultrasound, Non-palpable tumors, Intraoperative localization