ASO Author Reflections: Is the Era of Blind Breast Surgery Coming to an End? IOUS (Intra-Operative Ultrasound-guided Surgery)

Excerpt

BCS (breast conserving surgery) represents the established standard of care for the surgical treatment of early-stage breast cancer (BC). Many different localization techniques have been developed and proposed to guide BCS procedures. However, each technique has shown its own limitations: landmark displacement, poor accuracy, magnetic resonance artefacts, patient discomfort, radiology and nuclear medicine issues, extra costs. Moreover, all of them still make BCS essentially blind, as it lacks real-time direct visualization of tumors and continuous control of resection margins during surgical procedures. The literature reports positive margins rates ranging from 10 to 40%.¹ The involvement of resection margins is one of the strongest predictive factors for local recurrence, requiring additional surgical interventions and radiotherapy boost, thereby leading to increased healthcare costs, worse cosmetic outcomes and heightened stress for both surgeons and patients. IOUS has now become a proven effective and well-established practice in many other surgical oncology specialties, with liver surgery standing out as a prominent example. Although several studies have already demonstrated the efficacy of IOUS in BCS,² its implementation in this field of surgical oncology remains relatively novel and underutilized. …