Ultrasound-guided lumpectomy of nonpalpable breast cancers: A feasibility study looking at the accuracy of obtained margins

Background and Objectives: Complete excision of a nonpalpable breast cancer after wire localization is a difficult procedure. Often, adequate margins are not obtained, and a second procedure is then required. Prospectively, w e studied the feasibility of ultrasound-guided excisions of nonpalpable bre ast cancers, with particular attention to the accuracy of the procedure in obtaining adequate margins. Methods: Prospectively, 19 patients with 20 mammographically detected nonpa lpable, highly suspect, breast tumors were entered in this feasibility stud y. In 15 of these, the diagnosis of invasive malignancy was established pre operatively. All patients underwent ultrasound-guided excision with the int ent to obtain adequate margins. We also reviewed our own experience with th e excision of nonpalpable breast cancers after wire localization. Results: Of the 20 excisions with ultrasound guidance, there were 19 carcin omas and 1 ductal carcinoma in situ. Of the 19 carcinomas, 17 (89%) were ex cised with adequate margins. Of the 43 carcinomas that were excised after w ire localization, only 17 (40%) had been resected with adequate margins. Conclusions: Ultrasound-guided excision appears to be a reliable procedure for obtaining adequate margins in the resection of nonpalpable breast cance rs. Other advantages of this procedure ate increased patient comfort and de crease in operating room time. (C) 1999 Wiley-Liss, Inc.