Real-time tissue analysis gives Mayo Clinic much lower reoperation numbers than national rate
Unique laboratory testing during breast cancer lumpectomies to make sure surgeons remove all cancerous tissue spares patients the need for a repeat lumpectomy in roughly 96 percent of cases at Mayo Clinic in Rochester, a success rate much higher than the rate nationally, a Mayo study shows.
During the years reviewed, 13.2 percent of breast cancer lumpectomy patients nationally had to return to the operating room within a month of their initial surgery, compared to 3.6 percent at Mayo in Rochester, which uses a technique called frozen section analysis to test excised tissue for cancer while patient are still on the operating table. The findings are published in the journal Surgery.
In breast cancer lumpectomies, surgeons remove tumors with a small amount of normal tissue around them to help ensure they excised all of the cancer. This is known as obtaining “clean” or “negative” margins. During surgery at Mayo in Rochester, that tissue is transferred from the operating room to a nearby pathology lab, where the edges around the lumpectomy are shaved and each sample is frozen and reviewed under a microscope by a pathologist, all within minutes, while the patient is still anesthetized.
The pathologist immediately gives the surgeon the results, so the surgeon knows whether the lumpectomy is complete or there is still cancerous tissue to remove, and at which margin, before the operation concludes.
Mayo Clinic remains one of the only U.S. medical centers to perform frozen section analysis, and its process is unique, including use of a Mayo-modified microtome to freeze tissue so the pathologist can get a 360-degree view around the lumpectomy cavity.
“This intense pathological evaluation with the use of frozen section of the margins while the patient is asleep really drops down the re-excision rate,” says first author Judy Boughey, M.D., a breast surgeon in the Mayo Clinic Cancer Center. “Achieving negative margins in one operation has a huge impact on the patient’s satisfaction, decreases time away from work, time traveling back and forth to hospital appointments, and the financial cost to the patient, the insurance company and the hospital for a second operation.”
Mayo researchers compared 30-day reoperation rates for breast cancer lumpectomy patients at Mayo Clinic in Rochester with the reoperation rates for such patients at hospitals nationally as reported in American College of Surgeons National Surgical Quality Improvement Program data from 2006-10.
Patients in the national data were roughly four times likelier to undergo reoperation as those at Mayo in Rochester. The 30-day reoperation rate after lumpectomy for cancer was 13.2 percent nationally and 3.6 percent at Mayo in Rochester, the analysis found.
Unlike mastectomy — breast removal — a breast cancer lumpectomy typically preserves enough breast tissue to achieve an acceptable cosmetic result. Most women diagnosed with breast cancer have a choice between a lumpectomy and a mastectomy. However, women who have a lumpectomy and later learn another operation is needed to obtain negative margins may decide to get a mastectomy at that point, Dr. Boughey says.
The study’s senior author is Elizabeth Habermann, Ph.D., associate scientific director of the Surgical Outcomes Program in the Mayo Clinic Kern Center for the Science of Health Care Delivery. Mayo Clinic funded the research.
Sharon Theimer | EurekAlert!
NTU scientists build new ultrasound device using 3-D printing technology
07.12.2016 | Nanyang Technological University
How to turn white fat brown
07.12.2016 | University of Pennsylvania School of Medicine
In recent years, lasers with ultrashort pulses (USP) down to the femtosecond range have become established on an industrial scale. They could advance some applications with the much-lauded “cold ablation” – if that meant they would then achieve more throughput. A new generation of process engineering that will address this issue in particular will be discussed at the “4th UKP Workshop – Ultrafast Laser Technology” in April 2017.
Even back in the 1990s, scientists were comparing materials processing with nanosecond, picosecond and femtosesecond pulses. The result was surprising:...
Have you ever wondered how you see the world? Vision is about photons of light, which are packets of energy, interacting with the atoms or molecules in what...
A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.
Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...
In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.
“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...
The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.
The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...
16.11.2016 | Event News
01.11.2016 | Event News
14.10.2016 | Event News
07.12.2016 | Health and Medicine
07.12.2016 | Life Sciences
07.12.2016 | Health and Medicine