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William J. Gradishar, MD, FACP, FASCO


EBCC 2022: Study Reports Benefits of Ultrasound-Guided Surgery for Ductal Carcinoma In Situ

By: Susan Reckling
Posted: Friday, December 2, 2022

Based on the findings of a study of more than 100 women diagnosed with ductal carcinoma in situ, the use of intraoperative ultrasound enabled surgeons to decrease excision of healthy breast tissue while increasing the rates of negative surgical margins compared with the standard technique of wire localization. In addition, the ultrasound-guided surgery also reduced the risk of patients requiring a second surgery as well as reduced pain and preoperative stress for patients. These findings were presented by Antonio J. Esgueva, MD, of Clinica Universidad de Navarra, Breast Cancer Unit, Madrid, and colleagues at the 2022 European Breast Cancer Conference (EBCC; presentation number PB-003).

“This research is promising because it shows that a kinder technique can help guide surgeons to effectively remove ductal carcinoma in situ from the breast while minimizing unwanted side effects,” Co-Chair of the EBCC Laura Biganzoli, MD, of Santo Stefano Hospital, Prato, Italy, who was not involved in the research, stated in a press release.

The study included 108 patients, with 38% (n = 41) undergoing ultrasound-guided surgery and 62% (n = 67) undergoing surgery guided by wire localization. Although there were no differences in the tumor size or grade between the two groups, those treated with intraoperative ultrasound were younger and had ductal carcinoma in situ with comedonecrosis.

Patients treated with intraoperative ultrasound had smaller surgical volumes (21.86 vs. 47.18 cm3; P = .07) and a significantly smaller calculated resection ratio (1.6 vs. 2.9; P = .03). Just two patients (4.8%) treated with intraoperative ultrasound had positive surgical margins and needed a second operation, whereas seven patients (10.4%) whose surgery included wire localization had positive margins and needed a second operation. The re-excision rate was also lower with intraoperative ultrasound (P = .08). In addition, no differences in disease-free survival were observed, at a follow-up of 18.2 months, and cancer has recurred in one patient (treated with wire localization).

Disclosure: The study authors reported no conflicts of interest.

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