乳房标本定向的新方法:避免标本板概念的陷阱。
A New Approach to Breast Specimen Orientation: Avoiding Pitfalls with the Specimen Plate Concept.
发表日期:2024 Aug 10
作者:
András Drozgyik, Tamás Szabó, György Kovács, Dániel Kollár, Tamás F Molnár
来源:
Burns & Trauma
摘要:
在乳腺癌手术过程中,准确的标本标记至关重要,以避免方向错误,从而导致重新切除不充分和肿瘤复发。我们研究了各个乳腺癌中心的标记方法,以创建一种可以防止样本定向错误的工具。使用在线问卷调查匈牙利主要乳腺癌中心的标记程序,并使用故障排除方法开发了一个工具。二十个单位中有十二个作出回应(60%)。九个使用机构标准化的评分系统。不到一半的手术团队发现样本乳房X光检查是明确的。在超过 70% 的科室中,病理学家不确定乳腺标本的方向。在一半的情况下,模糊的标记方法会导致方向错误,而不清楚的标记方向会导致其余的情况。大多数病理学家(85%)和外科医生(75%)认为冠状平面标本乳房X光检查将有助于解决问题。已经开发出一种塑料标本板,用于将乳腺组织锚定到乳房 X 线摄影图像中看到的冠状乳腺方案,从而在整个手术过程中提供清晰的定位信息。匈牙利的乳房标本方向和标记缺乏标准化。正在开发优化的定向工具包,以确保外科医生和病理学家对乳房 X 光检查样本的解释一致。
Accurate specimen marking is crucial during breast cancer surgery to avoid misorientation, which can lead to inadequate re-excision and tumor recurrence. We studied the marking methods at various breast cancer centers to create a tool that would prevent specimen misorientation. An online questionnaire was used to survey marking procedures at major breast cancer centers in Hungary, and a tool was developed using a troubleshooting method. Twelve out of twenty units responded (60%). Nine use an institutionally standardized marking system. Less than half of the surgical teams found specimen mammograms to be unambiguous. In more than 70% of departments, pathologists were uncertain about breast specimen orientation. Ambiguous marking methods caused orientation errors in half of the cases, while unclear marking directions caused the rest. Most pathologists (85%) and surgeons (75%) believed that coronal plane specimen mammography would help solve the problem. A plastic specimen plate has been developed to anchor breast tissue to a coronal breast scheme as seen in mammography images, providing clear localization information throughout the surgical process. There is a lack of standardization in breast specimen orientation and marking in Hungary. An optimized orientation toolkit is being developed to ensure consistent interpretation of specimen mammograms by surgeons and pathologists.