Research

The effect of intraoperative specimen inking on lumpectomy re-excision rates

Mansher Singh^1,2 , Gayatri Singh² , Kevin T Hogan¹ , Kristen A Atkins³ and Anneke T Schroen¹

¹  Department of Surgery, University of Virginia, Charlottesville, Virginia, 22908, USA

²  Department of Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India

³  Department of Pathology, University of Virginia, Charlottesville, Virginia, 22908, USA

author email corresponding author email

World Journal of Surgical Oncology 2010, 8:4doi:10.1186/1477-7819-8-4

Published:	18 January 2010

Abstract

Background

Lumpectomy re-excision to obtain negative margins is common. We compare the effect of two specimen orientation approaches on lumpectomy re-excision rates.

Methods

All women undergoing lumpectomy for breast cancer by a single surgeon between 03/2007 - 02/2009 were included. Lumpectomies underwent standard inking (SI) after surgery by a pathologist from 03/2007-02/2008 while intraoperative inking (II) with direct surgeon input was done from 03/2008-02/2009. Rates of margin positivity and re-excision were compared between these methods.

Results

65 patients were evaluated, reflecting SI in 39 and II in 26 cases. Margin positivity rates of 46% [SI] vs. 23% [II] (p = 0.06) and re-excision rates of 38% [SI] vs. 19% [II] were observed. Residual disease at re-excision was found in 27% [SI] vs. 67% [II] of cases.

Conclusions

Intraoperative inking in this practice offered a simple way to reduce re-excision rates after lumpectomy and affect an improvement in quality of patient care.