Resection Ratios and Tumor Eccentricity in Breast-Conserving Surgery Specimens for Surgical Accuracy Assessment
by
, , ,
Dinusha Veluponnar
1,2,*,
Behdad Dashtbozorg
1
,
Marcos Da Silva Guimaraes
3,
Marie-Jeanne T. F. D. Vrancken Peeters
1,4,
Lisanne L. de Boer
1 and
Theo J. M. Ruers
1,2 1
Department of Surgery, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
2
Department of Nanobiophysics, Faculty of Science and Technology, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands
3
Department of Pathology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
4
Department of Surgery, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
*
Author to whom correspondence should be addressed.
Cancers 2024, 16(10), 1813; https://doi.org/10.3390/cancers16101813
Submission received: 17 April 2024
/
Revised: 30 April 2024
/
Accepted: 2 May 2024
/
Published: 9 May 2024
(This article belongs to the Special Issue Recent Advances and Challenges in Breast Cancer Surgery)
Simple Summary
This study aims to define and calculate several specimen parameters that would allow to determine the surgical accuracy of breast-conserving surgeries (BCS) in a representative population of patients. These specimen parameters included the ratio of specimen volume to tumor volume with different optimum margin widths (edges containing healthy tissue) and the tumor eccentricity, which is a measure for how centrally the tumor is located in the excised specimen. When using a surgical margin width of 0 mm, 1 mm, 2 mm, and 10 mm, on average 19.16 (IQR 44.36), 9.94 (IQR 18.09), 6.06 (IQR 9.69) and 1.35 (IQR 1.78) times the ideal resection volume got excised, respectively. The median tumor eccentricity was 11.29 mm (SD = 3.99) and the median relative tumor eccentricity was 0.66 (SD = 2.22). These parameters could be used to compare surgical accuracy when evaluating new technologies for intraoperative BCS guidance in the future.
Abstract
This study aims to evaluate several defined specimen parameters that would allow to determine the surgical accuracy of breast-conserving surgeries (BCS) in a representative population of patients. These specimen parameters could be used to compare surgical accuracy when using novel technologies for intra-operative BCS guidance in the future. Different specimen parameters were determined among 100 BCS patients, including the ratio of specimen volume to tumor volume (resection ratio) with different optimal margin widths (0 mm, 1 mm, 2 mm, and 10 mm). Furthermore, the tumor eccentricity [maximum tumor-margin distance − minimum tumor-margin distance] and the relative tumor eccentricity [tumor eccentricity ÷ pathological tumor diameter] were determined. Different patient subgroups were compared using Wilcoxon rank sum tests. When using a surgical margin width of 0 mm, 1 mm, 2 mm, and 10 mm, on average, 19.16 (IQR 44.36), 9.94 (IQR 18.09), 6.06 (IQR 9.69) and 1.35 (IQR 1.78) times the ideal resection volume was excised, respectively. The median tumor eccentricity among the entire patient population was 11.29 mm (SD = 3.99) and the median relative tumor eccentricity was 0.66 (SD = 2.22). Resection ratios based on different optimal margin widths (0 mm, 1 mm, 2 mm, and 10 mm) and the (relative) tumor eccentricity could be valuable outcome measures to evaluate the surgical accuracy of novel technologies for intra-operative BCS guidance.
