Accuracy of Specimen Radiography in Assessing Complete Local Excision with Breast-Conservation Surgery

Document Type: Research Articles

Authors

1 Departments of Diagnostic Radiology and Medicine, Aga Khan University Hospital, Karachi, Pakistan.

2 Radiology, Aga khan University Hospital Karachi,PakistanشDepartments of Diagnostic Radiology and Medicine, Aga Khan University Hospital, Karachi, Pakistan.

Abstract

Objective: The aim of this study was to evaluate the accuracy of “X- ray examination of surgically
resected specimen‘‘ in assessing complete local excision (CLE). Materials and Methods: In this retrospective cross
sectional study, data were collected for all female breast cancer cases who underwent breast-conserving surgery after
needle localization of mammographically visible disease. Males, patients with mammographically invisible disease
and cases with benign or inconclusive histopathology, those undergoing modified radical mastectomy and individuals
with dense breast parenchyma were excluded. We evaluated radiography of resected specimens to assess margin
spiculation, distance of mass/microcalcification from the excised margin, presence of a mass, and presence of any
adjacent microcalcification, Other features including mass size, nuclear grade and patient’s age were also recorded and
all were analyzed for any association with CLE. Results: Absence of adjacent microcalcification and the presence of a
mass on radiographs showed significant associations with CLE, but no links were evident with other features. Specimen
radiography was found to be a sufficient tool to predict CLE with a positive predictive value of 83.3%, a sensitivity of
80.7% and a specificity of 81%. Conclusion: Specimen radiography is an important and sensitive tool to predict CLE.

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