A comparative study for the efficacy of ISM versus SSM for marginal status of MMG-guided excisional biopsy
Journal
Asian Journal of Surgery
Journal Volume
49
Journal Issue
1
Start Page
83-89
ISSN
1015-9584
Date Issued
2026-01
Author(s)
Huang, Kuan-Jie
Tsai, Yi-Fang
Lee, Po-Ying
Lin, Yen-Shu
Feng, Chin-Jung
Chen, Yen-Chen
Chiu, Jen-Hwey
Lai, Yi-Chen
Huang, Chi-Cheng
Tseng, Ling-Ming
Abstract
Background: Specimen mammography (SM) is routinely used to assess surgical margins in non-palpable mammography (MMG)-detected breast lesions. Standard specimen MMG (SSM) requires physical transportation, which is time-consuming, while intraoperative specimen MMG (ISM) offers an alternative. This study compares outcomes of ISM and SSM regarding margin status and reoperation rates. Methods: We retrospectively analyzed 1119 patients who underwent MMG-guided wide excision from October 2017 to August 2021. Specimens were assessed via SSM (n = 579) or ISM (n = 537). Outcomes included operative time, margin status, and re-excision rates. Comparisons were adjusted for clinical and pathological variables. Results: ISM showed a significantly lower positive margin rate than SSM (8.73 % vs. 21.2 %, p = 0.009). Among malignancies, invasive ductal carcinoma (IDC) had a higher re-excision rate than ductal carcinoma in situ (DCIS) (73.21 % vs. 21.3 %, p < 0.001). Positive margin rates were higher in IDC (28.57 % vs. 10 %, p = 0.004). ISM significantly reduced positive margins in IDC (8.3 % vs. 40.6 %, p = 0.007). Comedo-type DCIS had a higher re-excision rate than non-comedo DCIS (32.7 % vs. 15.3 %, p = 0.009). Conclusion: ISM improves margin clearance and efficiency compared to SSM, particularly in IDC cases, while comedo-DCIS remains associated with higher re-excision rates.
Publisher
Elsevier BV
Type
journal article