Edward St John

Reducing the Margins of Error During Breast-Conserving Surgery: Disruptive Technologies or Traditional Disruptions?

Scale of Reoperative Breast Cancer Surgery Breast-conserving surgery (BCS), when optimally delivered, offers local oncological control of breast cancer with preservation of quality of life.1 These benefits are traded off against reoperation for inadequate resection margins and the need for postoperative breast irradiation. Reoperation for failed BCS is a major health care and societal challenge.2 In the United States, data from the American Society of Breast Surgery (ASBS) Mastery Program database suggests an aggregate reoperation rate of 21.6%,3 with similar average rates observed in the United Kingdom.2 Reoperation precipitates patient anxiety, degrades cosmesis, delays receipt of adjuvant therapy, and is cost-inefficient. A health economic analysis of an estimated 140 000 women undergoing BCS per annum in the United States computed reintervention costs of

Rapid evaporative ionisation mass spectrometry of electrosurgical vapours for the identification of breast pathology: towards an intelligent knife for breast cancer surgery

228.4 million for positive margins alone.4 Given the escalation in breast cancer diagnoses and the projected trajectory of BCS in future years, there may come a point where the costs of reoperative intervention become economically prohibitive.4