ABSTRACT
Rates of re-excision and re-operation following routine breast-conserving surgery for both palpable and impalpable lesions remains high, and this has spurred efforts to develop reliable intraoperative assessment tools which can provide a timely indication of whether re-excision of a cavity margin is indicated at the time of primary surgery. Many surgeons perform intraoperative radiological assessment of impalpable lesions using portable x-ray devices such as the Faxitron. Several emergent technologies exist which can potentially improve intraoperative margin assessment and thereby reduce rates of re-excision. The advent of oncoplastic surgery has permitted wide resection of breast tissue with tumor-free margins such that more than 20% of breast volume can be removed in non-cosmetically sensitive zones of the breast. Surgical margin status is considered a major predictor of ipsilateral breast tumor recurrence, but no consensus on what constitutes an “adequate” width of surgical margin existed until publication of an international consensus statement in 2014.
