An evaluation of intraoperative digital specimen mammography versus conventional specimen radiography for the excision of nonpalpable breast lesions

BACKGROUND: This study examined the impact of intraoperative digital specimen mammography (IDSM) compared with conventional specimen radiography (CSR) for nonpalpable breast lesions in patients undergoing breast-conserving surgery (BCS). METHODS: In this retrospective cohort study, 201 consecutive image-detected nonpalpable breast lesions underwent BCS after preoperative localization and specimen radiography. Data on patient, tumor, and surgical factors were collected. RESULTS: CSR was performed in 105 patients and IDSM was used in 96 patients. Patient and tumor factors were similar in both groups. Using univariate analysis, CSR resulted in more positive margins (19% vs 6.2%; P = .012). Rates of cavity margin resection, reoperation, and operative times were similar for CSR and IDSM. Independent predictors of positive margins on multivariable analysis were use of CSR, microcalcifications on mammography, the need for bracketing for localization, and no cavity margin excision (all P < .05). CONCLUSIONS: In this study, the use of IDSM resulted in fewer positive margins after BCS, although operative times were similar.