Unveiling a Surgical Revolution : The Use of Conventional Histology versus Ex Vivo Fusion Confocal Microscopy in Breast Cancer Surgery
Humaran, Daniel (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Pérez-Anker, Javiera (Hospital Clínic i Provincial de Barcelona)
Fernández, Pedro Luis (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Blay, Lidia (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Pascual, Iciar (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Castellà Fernández, Eva (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Pérez, Laia (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Puig, Susana (Hospital Clínic i Provincial de Barcelona)
Malvehy, Josep (Hospital Clínic i Provincial de Barcelona)
Julián, Joan F. (Universitat Autònoma de Barcelona. Departament de Cirurgia)

Fecha:	2024
Resumen:	Ex vivo fusion confocal microscopy (EVFCM) enables the rapid examination of breast tissue and has the potential to reduce the surgical margins and the necessity for further surgeries. Traditional methods, such as frozen section analysis, are limited by the distortion of tissue and artefacts, leading to false negatives and the need for additional surgeries. This study on observational diagnostic accuracy evaluated the ability of EVFCM to detect breast cancer. A total of 36 breast tissue samples, comprising 20 non-neoplastic and 16 neoplastic cases, were analysed using EVFCM and compared to the results obtained from routine histopathology. A Mohs surgeon experienced in EVFCM (evaluator A) and two breast pathologists unfamiliar with EVFCM (evaluators B and C) performed blinded analyses. EVFCM showed high concordance with the histopathology and the detection of neoplasia, with significant kappa values (p < 0. 001). Evaluator A achieved 100% sensitivity and specificity. Evaluators B and C achieved a sensitivity of >87%, a specificity of >94%, positive predictive values of >95%, and negative predictive values of 81% and 94%, respectively. EVFCM therefore offers a promising technique for the assessment of margins in breast-conserving surgery. Its widespread adoption could significantly reduce re-excisions, lower healthcare costs, and improve cosmetic and oncological outcomes.
Nota:	Altres ajuts: the JMC Legacy Research Fund of Germans Trias I Pujol University Hospital, LE2201-2021-03
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Breast cancer detection ; Breast conserving surgery ; Ex vivo fusion confocal microscopy ; Surgical pathology
Publicado en:	Cells, Vol. 13 (october 2024) , ISSN 2073-4409

DOI: 10.3390/cells13201692
PMID: 39451210

12 p, 9.6 MB

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