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Letter| Volume 49, ISSUE 3, P675-676, March 2023

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Next-generation margin evaluation techniques in breast conserving surgery: A memorandum on intraoperative flow cytometry

Published:April 20, 2022DOI:https://doi.org/10.1016/j.ejso.2022.04.009
      An article by Hoffman and Ashkenazi has been recently published in European Journal of Surgical Oncology, regarding the impact of MarginProbe in the evaluation of resection margins in breast conserving surgery, which we read with great interest [
      • Hoffman A.
      • Ashkenazi I.
      The efficiency of MarginProbe in detecting positive resection margins in epithelial breast cancer following breast conserving surgery.
      ]. The authors utilised MarginProbe to evaluate the status of a series of 302 resection margins during lumpectomies, corresponding to 51 tumours and 48 patients and compared their results with the final pathological analysis. Of them, 13 margins were considered positive by pathological evaluation (tumour cells adjacent within 1 mm or less to the inked surface) and MarginProbe was successfully evaluated 3 out 13 these margins as positive. In addition, out of 289 confirmed negative margins (uninvolved during pathological evaluation), MarginProbe evaluated 97 as potentially positive. Overall, the sensitivity and specificity of MarginProbe has been calculated as 23.1% and 66.4%, respectively.
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      References

        • Hoffman A.
        • Ashkenazi I.
        The efficiency of MarginProbe in detecting positive resection margins in epithelial breast cancer following breast conserving surgery.
        Eur J Surg Oncol. 2022; https://doi.org/10.1016/j.ejso.2022.02.021
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        • et al.
        Rapid assessment of resection margins during breast conserving surgery using intraoperative flow cytometry.
        Clin Breast Cancer. 2021; 21: e602-e610https://doi.org/10.1016/j.clbc.2021.03.002
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        The past, present and future of flow cytometry in central nervous system malignancies.
        Methods Protoc. 2021; 4https://doi.org/10.3390/mps4010011

      Linked Article

      • Reply to: Next-generation margin evaluation techniques in breast conserving surgery: A memorandum on intraoperative flow cytometry
        European Journal of Surgical OncologyVol. 48Issue 6
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          Thank you for sharing the results of Vartholomatos et al., who used intraoperative flow cytometry (iFC) and demonstrated very high sensitivity and specificity rates in identifying neoplastic cells in a given lumpectomy specimen margin [1]. Achieving clear lumpectomy margins is necessary to avoid the need for reoperation and to diminish the rates of ipsilateral breast recurrences. Several approaches and technologies have been suggested to lower the rates of involved/close margins. Yet, none have proved superior to others, and the search for an optimal method continues [2].
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