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ASBrS 2017: Lumpectomy and Excisional Biopsy in an Outpatient Setting

Image-guided, minimally invasive lumpectomy/excisional biopsy for small ductal carcinoma in situ (DCIS), invasive cancers, and high-risk lesions may be accomplished in an outpatient setting, based on the findings presented by Pat Whitworth, MD, of the Nashville Breast Center, at the recent American Society of Breast Surgeons (ASBrS) Annual Meeting (Abstract 257374) in Las Vegas, Nevada. With less tissue removal needed via smaller incisions not requiring sutures, this approach may reduce the morbidity, discomfort, and cost associated with overtreatment of small breast cancers. In addition, it might be an alternative for subsets of patients at high surgical risk.

A total of 281 women were included in the study. Small DCIS, invasive cancers, and high-risk lesions were removed via a 15- or 20-mm radiofrequency basket capture with imaging guidance. Tissue elasticity permitted removal of these tumors through a 12-mm incision.

Of 52 DCIS and 73 invasive lesions, 23 tumors (18.4%) had positive margins by histologic standards. Furthermore, 17 of 22 tumors with reported results (77.3%) had no residual lesion after open surgery. Patient-reported pain scores averaged 0.93 out of 10 (range, 0–6).