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!
Nanoparticle versus cancer
21.07.2016 | Lomonosov Moscow State University
Titanium + gold = new gold standard for artificial joints
21.07.2016 | Rice University
Researchers at the U.S. Department of Energy's (DOE) Ames Laboratory have discovered an unusual property of purple bronze that may point to new ways to achieve high temperature superconductivity.
While studying purple bronze, a molybdenum oxide, researchers discovered an unconventional charge density wave on its surface.
Munich Physicists have developed a novel electron microscope that can visualize electromagnetic fields oscillating at frequencies of billions of cycles per second.
Temporally varying electromagnetic fields are the driving force behind the whole of electronics. Their polarities can change at mind-bogglingly fast rates, and...
Breakup of continents with two speed: Continents initially stretch very slowly along the future splitting zone, but then move apart very quickly before the onset of rupture. The final speed can be up to 20 times faster than in the first, slow extension phase.phases
Present-day continents were shaped hundreds of millions of years ago as the supercontinent Pangaea broke apart. Derived from Pangaea’s main fragments Gondwana...
Scaffolding and specialised workers help with the delivery – Heidelberg biochemists gain new insights into biogenesis
A type of scaffolding on which specialised workers ply their trade helps in the manufacturing process of the two subunits from which the ribosome – the protein...
Scientists at the Helmholtz Zentrum München have developed a new mass spectrometry imaging method which, for the first time, makes it possible to analyze hundreds of metabolites in fixed tissue samples. Their findings, published in the journal Nature Protocols, explain the new access to metabolic information, which will offer previously unexploited potential for tissue-based research and molecular diagnostics.
In biomedical research, working with tissue samples is indispensable because it permits insights into the biological reality of patients, for example, in...
15.07.2016 | Event News
15.07.2016 | Event News
11.07.2016 | Event News
25.07.2016 | Materials Sciences
25.07.2016 | Power and Electrical Engineering
22.07.2016 | Information Technology