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10.1245/s10434-006-9126-5
Annals of Surgical Oncology 14:1478-1485 (2007)
© 2007 Society of Surgical Oncology
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Original Article

Intraoperative Digital Specimen Mammography: Rapid, Accurate Results Expedite Surgery

Cary S. Kaufman, MD1,2, Leslie Jacobson, MS2, Barbara A. Bachman, MD2, Lauren B. Kaufman, MD2, Carol Mahon, RN3, Laura-Jane Gambrell, RN3, Roger Seymour, RN3, Jennifer Briscoe, ST3, Karen Aulisio, RN3, Angi Cunningham, ST3, Francis Opstad, RN3, Nancy Schnell, RN3, Jan Robertson, RN3 and Lynne Oliver, RN3

1 Department of Surgery, University of Washington, Washington, USA
2 Bellingham Breast Center, 2940 Squalicum Parkway, Bellingham, WA 98225, USA
3 Bellingham Surgery Center, 2980 Squalicum Parkway, Bellingham, WA 98225, USA

Correspondence: Address correspondence and reprint requests to: Cary S. Kaufman, MD; E-mail: breastcare{at}aol.com

Introduction: Specimen mammography during image guided breast surgery is a daily occurrence. The process of specimen travel, imaging and reporting may take 20–30 minutes. An intraoperative method to obtain digital specimen mammograms may expedite the process. We compared intraoperative digital specimen mammography (IDSM) as well as standard specimen mammography (SSM) on 121 consecutive image guided lumpectomies.

Methods: Each lumpectomy specimen had IDSM obtained followed by travel to radiology for SSM. Surgical decisions were based on all imaging obtained. Data included 1) the ability of each imaging method to identify the target lesion, 2) degree of concordance of surgical interpretation of IDSM compared to radiologist interpretation of SSM, 3) the time required from lumpectomy to surgical review of images from each method, and 4) potential operative time savings.

Results: Intraoperative digital specimen mammography (IDSM) was equally as accurate as standard x-ray film specimen mammography. There was no significant difference between 1) the frequency of identification of the target lesion by surgeon or radiologist, 2) lack of identification of any lesion, or 3) frequency of involved margins using imaging criteria. However, there was a marked difference in 1) the time needed to obtain images ready to read, 2) the ability to re-excise tissue promptly, and 3) the overall operating room time with an average decrease of 19 minutes.

Conclusions: Intraoperative digital specimen mammography (IDSM) was equally accurate as SSM obtained in this study. Use of this new technology allows surgeons to quickly view specimen images which translate into shorter more efficient operations.

Key Words: Specimen mammography • Image guided breast biopsy • Digital mammogram • Cost-efficiency in breast surgery • Breast surgeon






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