Achieving clear margins. Directed shaving using MarginProbe, as compared to a full cavity shave approach

- MarginProbe decreases the amount of tissue removed during breast conserving surgery.
- MarginProbe decreases the rate of re-excision following breast conserving surgery.
- MarginProbe can decrease the amount of work for pathologists.

BackgroundFollowing lumpectomy, full cavity shaving approach is used to reduce positive margin rates, among other issues previously studied by others, at an expense of increase in tissue volume removed. We present our experience after switching from full cavity shaving to a targeted shaving approach using MarginProbe, an intra-operative margin assessment device.MethodsSpecimen excision was performed according to standard of care. Additional shavings were taken based on device readings on the lumpectomy specimen. Intra-operative imaging was used, as required.ResultsWe compared 137 MarginProbe cases to 199 full cavity shave cases. The re-excision rate was reduced by 57% (P = 0.026), from 15.1% to 6.6%. The overall tissue volume removed was reduced by 32% (P = 0.0023), from 115 cc to 78 cc.ConclusionsMarginProbe enabled a change in the lumpectomy technique from full cavity shavings to directed shavings guided by the device. There was a significant reduction in re-excisions and in the overall tissue volume removed.The lower amount of shavings also contributed to a reduction in pathology work.