Studies and Reports
Breast Cancer Study
In 2014, Dr. Gregory Senofsky from the Department of Surgery and Dr. Rashida Soni from the Department of Pathology at Henry Mayo Hospital presented a study at national and international platforms demonstrating significantly improved breast cancer care at a community hospital using a multidisciplinary approach, proper pre-operative planning by breast surgeon and intraoperative evaluation of margins by breast pathologist.
CLICK HERE TO DOWNLOAD POSTER OF PRESENTATION: Improved local recurrence rate using a multidisciplinary approach, pre-operative planning and intraoperative gross and ink of the specimen for evaluation of margins.
Several well-controlled studies have demonstrated significantly increased local recurrence rates in patients with low-stage breast carcinoma treated with breast conservation therapy in whom focally positive margins or close (1 mm) margins were not re-excised. This occurs very commonly in many hospital settings with a national average of approximately 20% re-excision rate. The study, using two year data, demonstrated that our re-excision rate has dropped to 5% using a unique method, not offered in most institutions including many academic centers. We have a unique group of physicians; each one specialized in their own respective fields.
We utilized proper preoperative planning with Gadolinium MRI in addition
to standard mammogram and ultrasound bracketing J-wire technique. The
pathologist performs intraoperative ink and gross assessment of the lumpectomy
using a specific method and communicates with the surgeon while the patient
is still under anesthesia. Immediate re-excision of any margin thought
to be less than 5.0 millimeters is performed and relabeled after discussion
by the surgeon with the radiologist and the pathologist. Oncoplastic closure
is performed. This method has reduced our re-excision rate to 5% as compared
to national average of 15-20% without this method.
This is an accurate, simple, rapid and cost-effective method for determining the margin status of breast conservative therapy specimens intraoperatively in the community hospital setting. This method allows a survey of the entire lumpectomy specimen, and allows the surgeon to complete the margins in one surgery reducing the need for re-operation thus reducing patient’s anxiety, complications and reducing health care cost.