[Specimen radiography assessment of surgical margins status in subclinical XXXX : a diagnostic study].

@entity1 @entity3821 @entity0 @entity2286 @entity189
OBJECTIVE: This study aimed to determine the accuracy of specimen radiography in evaluating the surgical margins of impalpable @entity0 . DESIGN AND SETTING: Retrospective study from June 2009 to June 2010 in Orleans Hospital Center. @entity1 AND METHODS: The study involved @entity1 with impalpable in situ @entity0 diagnosed by mammography. Only @entity1 with larger in situ @entity189 than @entity189 were included. @entity1 underwent a breast conserving surgery after preoperative localization of the lesion. PRIMARY ENDPOINT: Sensitivity, specificity, positive predictive value ( @entity2286 ) and negative predictive value (NPV) of the specimen radiography are determined by correlation between radiologic and histologic margins. RESULTS AND DISCUSSION: The following results were obtained from 46 @entity1 : 36 @entity3821 cases (78%), six @entity3821 with IDC cases (13%), two LCIS cases (4%) and two biopsy suggested @entity3821 (4%). A radiologic margin of 2mm (by analogy with the histological margins) results in a NPV of 73%. NPV, sensibility and specificity were respectively 79, 60 and 74% for a radiologic margin of 5mm. The measure or inter-rater reliability found a moderate agreement (kappa: 0.62). The systematic review on this topic found only eight articles (small samples and only two prospective studies). We could not make any recommendations from the literature review on a threshold to define excision margin status. CONCLUSION: The specimen radiography is a useful tool to assess margins of impalpable @entity0 . However, further studies are necessary as this point to determine a threshold for those radiologic margins.
