THE EFFICACY OF SPECIMEN RADIOGRAPHY IN EVALUATING THE SURGICAL MARGINS OF IMPALPABLE BREAST-CARCINOMA

OBJECTIVE. The purpose of this study was to determine if the presence or absence of tumor at the surgical margin in cases of impalpable brea st carcinoma could be predicted accurately with specimen radiography. MATERIALS AND METHODS. We obtained single-view radiographs of 119 cons ecutive surgical biopsy specimens of impalpable invasive or in situ du ctal carcinoma. Radiographic lesions were classified as a mass with mo derately well defined margins, a mass with poorly defined margins, or microcalcifications without an associated mass. The radiographic appea rance of the impalpable cancer, the margin as judged from the specimen radiograph, the tumor's histologic appearance, and the histologic app earance of the tumor margin were then correlated. RESULTS. Specimen ra diographs showed tumor at the surgical margin in 63 cases; 62 of these were confirmed histologically (positive predictive value, 98%). Speci men radiographs showed tumor-free surgical margins in 56 cases; 18 of these were confirmed histologically (negative predictive value, 32%. T hese results were independent of the radiographic appearance of the le sion or the tumor's histologic appearance. CONCLUSION. Decisions based on findings on specimen radiographs were valid only if the radiograph s showed tumor at the margin of the specimen.