New procedures for determining resection margins during organ-sparing surgery in patients with breast cancer

Breast cancer (BC) occupies a leading place in the structure of cancers among the female population worldwide. The number of breast cancer patients currently tends to increase in the 30–45-year-old group. Organ-sparing treatment (OST) is recommended to improve quality of life in the patients. The operation involves the excision of a segment with a breast lump, but achievement of negative resection margins is mandatory. The latest data show that to achieve the purity of resection margins, indents of up to 2 mm and 1 mm are currently recommended for ductal carcinoma in situ and an invasive form, respectively. Despite the existing data on the safety and benefits of OST, 20 to 30% of patients with invasive or non-invasive BC usually undergo a reoperation. The increased number of repeated resections, and especially mastectomies, leads to severe psychological and physical traumas in women, substantially worsening the quality of life. It is important to correctly mark resection margins during surgery. The paper presents up-to-date methods to examine resection margins intraoperatively. It includes techniques, such as micro-CT, Cherenkov luminescence imaging, radiofrequency spectroscopy-based “Margin Probe”, and fluorescence imaging. The use of the most promising techniques and their long-term results are described. © A group of authors, 2020.