Localización de lesiones mamarias subclínicas con marcador metálico (arponaje): Análisis de los márgenes quirúrgicos

Gustavo Febles; José Parada; Enrique Folle; Carlos Pressa; Miguel Mate; Fernando Estellano; Susana Silveira; Guillermo Laviña; Víctor Laxalt

Authors

Gustavo Febles Centro de Diagnóstico y Tratamiento Mamario. Médico Imagenólogo
José Parada Centro de Diagnóstico y Tratamiento Mamario. Médico Imagenólogo
Enrique Folle Centro de Diagnóstico y Tratamiento Mamario. Médico Cirujano
Carlos Pressa Centro de Diagnóstico y Tratamiento Mamario. Médico Cirujano
Miguel Mate Centro de Diagnóstico y Tratamiento Mamario. Médico Cirujano
Fernando Estellano Centro de Diagnóstico y Tratamiento Mamario. Médico Cirujano
Susana Silveira Centro de Diagnóstico y Tratamiento Mamario. Médico Cirujano
Guillermo Laviña Centro de Diagnóstico y Tratamiento Mamario. Médico Cirujano
Víctor Laxalt Centro de Diagnóstico y Tratamiento Mamario. Médico Cirujano

Keywords:

BREAST NEOPLASMS, SURGICAL DIAGNOSTICS TECHNIQUES

Abstract

Introduction: lesion resection with tumor free margins is the objective in breast cancer. If there is a tumor in the surgical margin the rates of recurrence will be higher.
Objectives: to evaluate the experience at the Centro de Diagnóstico Mamario (CENDIMA – Breast Diagnosis Center) of the Asociación Española Primera de Socorros Mutuos, in terms of conservative surgery of breast cancer guided by metal markers. The surgical margins width and the factors associated with the positive margins are studied.
Method: we analysed all cases of subclinical breast cancer treated with conservative surgery guided by metal markers from January 2007 through December 2009 (147 cases).
Results: margins were positive (in contact with the lesion or nearest margin width was up to 1mm) in 39 cases (26%) and negative (width was 22 mm or larger) in 108 cases (74%).
Average lesion size was greater the positive margin cases (15,6 mm compared to 11,4 mm).
An in-situ ductal component was more frequently observed among the positive margins population (82% compares to 42%), and microcalcifications were more frequent in mammographic images (51% compared to 14%). Re-excision due to insufficient margins was performed in 42 cases (29%) and residual tumors were found in 21 of these cases (50%).
Conclusion: the profile of the lesion that is more likely to evidence positive surgical margins after a conservative surgery guided by a metal marker is the following: lesion greater than 10 mm, with an in-situ component in its histology and microcalcification observed in the image.

References

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