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Federación Mexicana de Ginecología y Obstetricia, A.C.

2009, Number 09

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Ginecol Obstet Mex 2009; 77 (09)

Radiological control intraoperatory of a surgical piece in non palpable breast lesions

Ruvalcaba LE, Espejo FR, Bautista PV, Madero PL, Capurso GM, Serratos GJE, Guisa HF, Rodríguez CS

Language: Spanish
References: 36
Page: 407-418
PDF size: 443.56 Kb.


ABSTRACT

Background: nonconcrete the mammary injuries are frequent in programs of detection of breast cancer, estereotaxic or ecographic marking is required to realize its split. The intrasurgical radiation control of the surgical piece is indispensable to evaluate the margins of the mammary cancer.
Objective: to determine the effectiveness of the intrasurgical radiation control of the surgical piece in nonconcrete mammary injuries to diminish the surgical reinterventions to extend margins.
Patients and method: women with nonconcrete mammary injuries to those who biopsy by split became, previous marking and intraoperating radiation control of the surgical piece to value margins (suitable margin the same or major of 10 mm, smaller inadequate margin of 10 mm). Intrasurgical reesicion in inadequate radiological margins became. The demographic characteristics, masto-ecographics images, histopathology of the injuries and the radiological-histopatológica correlation of the margins studied. Cross-sectional, prospective and descriptive study.
Results: 103 patients with 113 nonconcrete mammary injuries included themselves, with age average of 51,35 (32-73) years. In all the injuries the intrasurgical radiation control became of the surgical piece. The prevalence of mammary cancer was of 28,3% (32/113), that corresponds to stellar images (42,8%), suspicious microcalcifications with density (39,2%), microcalcifications (31,2%) and nodules (20%). Of the 32 cancers, 16 had inadequate radiological margins that required intraoperating reescision; suitable histopatologic margins in 100% were obtained (16/16). The 16 (62,5%) cancers without intraoperating reescisión by suitable radiological margins had suitable histopatologic margins and 37,5% (6/16) inadequate ones that required surgical reintervención to control the margins. The discrepancy between margins was related to microcalcifications in 83.3% of the injuries.
Conclusions: the intrasurgical radiation control of the surgical piece is effective to evaluate margins; the intrasurgical reescisión changed inadequate margins to suitable in 50% (16/32) of the cancers; only 18,7% (6/32) of the total of cases required another surgery to control the margins.


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