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Intraoperative evaluation of the resection margin with the usage of digital two-point sectorography (Faxitron PathVision)
- Authors: Bondarchuk Y.I.1, Zhiltsova E.K.1, Krivorotko P.V.1, Pesotskiy R.S.1, Emelyanov A.S.1, Tabagua T.T.1, Gigolaeva L.P.1, Yereshchenko S.S.1, Komyakhov A.V.1, Nikolaev K.S.1, Zernov K.Y.1, Semiglazov V.V.1, Paltuev R.M.1, Mortada V.V.1, Shaykhelislamova L.F.1, Enaldieva D.A.1, Amirov N.S.1, Channov V.S.1, Artemyeva A.S.1, Chernaya A.V.1, Ulyanova R.K.1, Semiglazov V.F.1
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Affiliations:
- N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
- Issue: Vol 18, No 4 (2022)
- Pages: 43-51
- Section: MAMMOLOGY. ORIGINAL REPORTS
- Published: 01.12.2022
- URL: https://ojrs.abvpress.ru/ojrs/article/view/1040
- DOI: https://doi.org/10.17650/1994-4098-2022-18-4-43-51
- ID: 1040
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Abstract
Background. Surgery is fundamental in complex and combined approach in the treatment of the early breast cancer. It is a common fact, that absence of tumor cells in the resection margin is the main indicator of oncological safety of the breast-conserving surgery (BCS). The presence of tumor cells in examined margin is the predictor of local recurrence after BCS for breast cancer. Currently the clinical need for precise and fast method of intraoperative assessment of the resection margin status is kept. Intraoperative evaluation of the resection margin with the usage of digital two-point sectorography (Faxitron PathVision) appeared as the alternative to intraoperative histological examination, providing the optimum size of the information about adequacy of the carried out surgical treatment.
Aim. To evaluate diagnostic features of the digital two-point sectorography Faxitron PathVision in the intraoperative assessment of the resection margin status after the surgical treatment in comparison with planned histologic examination.
Materials and methods. 368 conducted conservative surgeries were analyzed; patients were divided in two groups depending on neoadjuvant chemotherapy. The first group of patients included 236 patients, who didn't receive neoadjuvant chemotherapy before surgery; second group included 132 patients, who received neoadjuvant chemotherapy. Subset analysis of detection rate of the positive resection margin (R1) was carried out with the usage of the intraoperative assessment of the resection margin on the X-ray device Faxitron PathVision or without this method. After each BCS resection margin status was assessed on planned histologic examination for the presence of the tumor cells, with subsequent analysis of the frequency of reoperations when R1 was found.
Results. In 368 tested surgical specimens after BCS R1 was found in 25 cases, which is 6.8 %. From 236 patients in the first group after BCS R1 was found in 20 cases, which is 8.5 %; from 132 conducted operations in the second group in 5 (3.8 %) cases the presence of R1 is found. Reoperations were performed in 13 cases and tumor cells were found in 3 cases in the sub-group which didn't receive intraoperative assessment with X-ray device Faxitron PathVision.
Conclusions. Assessing the results of our study we can make a conclusion about the positive experience of performing BCS and intraoperative evaluation of the resection margin with the usage of the digital two-point sectorography (Faxitron PathVision) and low frequency of R1 (3.8 %) in comparison with absence of this method (8.5 %).
About the authors
Ya. I. Bondarchuk
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
Author for correspondence.
Email: yana_bondarchuk_2015@mail.ru
ORCID iD: 0000-0002-6442-0106
Yana I. Bondarchuk.
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationE. K. Zhiltsova
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0002-2029-4582
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationP. V. Krivorotko
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0002-4898-9159
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationR. S. Pesotskiy
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0002-2573-2211
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationA. S. Emelyanov
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0002-0528-9937
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationT. T. Tabagua
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0003-1471-9473
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationL. P. Gigolaeva
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0001-7654-4336
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationS. S. Yereshchenko
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0002-5090-7001
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationA. V. Komyakhov
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0002-6598-1669
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationK. S. Nikolaev
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0003-3377-6369
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationK. Yu. Zernov
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0002-2138-3982
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationV. V. Semiglazov
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0002-8825-5221
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationR. M. Paltuev
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0002-0871-9453
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationV. V. Mortada
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0002-1982-5710
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationL. F. Shaykhelislamova
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0001-9623-3877
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationD. A. Enaldieva
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0002-2773-3111
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationN. S. Amirov
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0002-2421-3284
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationV. S. Channov
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0001-8156-389X
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationA. S. Artemyeva
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0002-2948-397X
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationA. V. Chernaya
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0002-7975-3165
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationR. Kh. Ulyanova
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0001-9007-5900
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationV. F. Semiglazov
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
ORCID iD: 0000-0003-0077-9619
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationReferences
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