Intra-operative assessment of excision margins using breast imprint and scrape cytology

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Local recurrence in breast cancer surgery is related to the completeness of excision. Histological analysis of excision margins is time consuming and impractical for use intra-operatively. Our group evaluated breast imprint and scrape cytology (ISC) for the assessment of excision margins in a feasibility study in 1993-4, with 10 year clinical follow-up. Twenty-six consecutive women undergoing 27 wide local excisions for breast cancer had excision margins prospectively assessed with intra-operative ISC blinded to histology. All ISC results were ready (range 22-30 min) before surgery was completed. ISC agreed with histology in 21/27 (=78%) and disagreed in 6/27 (=22%) of the cases. In two cases with local recurrence, histology was positive in one case, whereas ISC margins were positive in both. Intra-operative ISC is reliable and could help the surgeon to excise more tissue to prevent a second (re-excision) operation. ISC margins may predict clinical outcome, although a larger interventional follow-up study is required. © 2004 Elsevier Ltd. All rights reserved.




Muttalib, M., Tai, C. C., Briant-Evans, T., Maheswaran, I., Livni, N., Shousha, S., & Sinnett, H. D. (2005). Intra-operative assessment of excision margins using breast imprint and scrape cytology. Breast, 14(1), 42–50.

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