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de Boer LL, Kho E, Nijkamp J, Van de Vijver KK, Sterenborg HJCM, ter Beek LC, Ruers TJM. Method for coregistration of optical measurements of breast tissue with histopathology: the importance of accounting for tissue deformations. J Biomed Opt 2019; 24:1-12. [PMID: 31347338 PMCID: PMC6995961 DOI: 10.1117/1.jbo.24.7.075002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 07/09/2019] [Indexed: 05/24/2023]
Abstract
For the validation of optical diagnostic technologies, experimental results need to be benchmarked against the gold standard. Currently, the gold standard for tissue characterization is assessment of hematoxylin and eosin (H&E)-stained sections by a pathologist. When processing tissue into H&E sections, the shape of the tissue deforms with respect to the initial shape when it was optically measured. We demonstrate the importance of accounting for these tissue deformations when correlating optical measurement with routinely acquired histopathology. We propose a method to register the tissue in the H&E sections to the optical measurements, which corrects for these tissue deformations. We compare the registered H&E sections to H&E sections that were registered with an algorithm that does not account for tissue deformations by evaluating both the shape and the composition of the tissue and using microcomputer tomography data as an independent measure. The proposed method, which did account for tissue deformations, was more accurate than the method that did not account for tissue deformations. These results emphasize the need for a registration method that accounts for tissue deformations, such as the method presented in this study, which can aid in validating optical techniques for clinical use.
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Affiliation(s)
- Lisanne L. de Boer
- The Netherlands Cancer Institute, Department of Surgery, Amsterdam, The Netherlands
| | - Esther Kho
- The Netherlands Cancer Institute, Department of Surgery, Amsterdam, The Netherlands
| | - Jasper Nijkamp
- The Netherlands Cancer Institute, Department of Surgery, Amsterdam, The Netherlands
| | - Koen K. Van de Vijver
- The Netherlands Cancer Institute, Department of Pathology, Amsterdam, The Netherlands
- Ghent University Hospital, Department of Pathology, Gent, Belgium
| | - Henricus J. C. M. Sterenborg
- The Netherlands Cancer Institute, Department of Surgery, Amsterdam, The Netherlands
- Amsterdam University Medical Center, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
| | - Leon C. ter Beek
- The Netherlands Cancer Institute, Department of Medical Physics, Amsterdam, The Netherlands
| | - Theo J. M. Ruers
- The Netherlands Cancer Institute, Department of Surgery, Amsterdam, The Netherlands
- University of Twente, Faculty of Science and Technology, Enschede, The Netherlands
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Abstract
Breast-conserving surgery (BCS) followed by radiation therapy is the current standard of care for early stage breast cancer. Successful BCS necessitates complete tumor resection with clear margins at the pathologic assessment of the specimen ("no ink on tumor"). The presence of positive margins warrants additional surgery to obtain negative final margins, which has significant physical, psychological, and financial implications for the patient. The challenge lies in developing accurate real-time intraoperative margin assessment techniques to minimize the presence of "ink on tumor" and the subsequent need for additional surgery.
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Toss MS, Pinder SE, Green AR, Thomas J, Morgan DAL, Robertson JFR, Ellis IO, Rakha EA. Breast conservation in ductal carcinomain situ(DCIS): what defines optimal margins? Histopathology 2016; 70:681-692. [DOI: 10.1111/his.13116] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Michael S Toss
- Department of Histopathology, Division of Cancer and Stem Cells, School of Medicine; The University of Nottingham, Nottingham City Hospital; Nottingham UK
| | - Sarah E Pinder
- Department of Research Oncology; King's College London, Guy's Hospital; London UK
| | - Andrew R Green
- Department of Histopathology, Division of Cancer and Stem Cells, School of Medicine; The University of Nottingham, Nottingham City Hospital; Nottingham UK
| | - Jeremy Thomas
- Department of Pathology; Western General Hospital; Edinburgh UK
| | - David A L Morgan
- Department of Oncology, Division of Cancer and Stem Cells, School of Medicine; The University of Nottingham, Nottingham City Hospital; Nottingham UK
| | - John F R Robertson
- Division of Breast Surgery, Graduate Entry Medicine and Health School (GEMS); University of Nottingham, Royal Derby Hospital; Derby UK
| | - Ian O Ellis
- Department of Histopathology, Division of Cancer and Stem Cells, School of Medicine; The University of Nottingham, Nottingham City Hospital; Nottingham UK
| | - Emad A Rakha
- Department of Histopathology, Division of Cancer and Stem Cells, School of Medicine; The University of Nottingham, Nottingham City Hospital; Nottingham UK
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Fitzgerald S, Romanoff A, Cohen A, Schmidt H, Weltz C, Bleiweis IJ, Jaffer S, Port ER. Close and Positive Lumpectomy Margins are Associated with Similar Rates of Residual Disease with Additional Surgery. Ann Surg Oncol 2016; 23:4270-4276. [DOI: 10.1245/s10434-016-5490-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Indexed: 11/18/2022]
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Persing S, Jerome MA, James TA, Callas P, Mace J, Sowden M, Goodwin A, Weaver DL, Sprague BL. Surgical margin reporting in breast conserving surgery: Does compliance with guidelines affect re-excision and mastectomy rates? Breast 2015; 24:618-22. [PMID: 26199197 PMCID: PMC4752196 DOI: 10.1016/j.breast.2015.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 04/08/2015] [Accepted: 06/21/2015] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Margin status is important in guiding decisions to re-excise following breast-conserving surgery (BCS) for breast cancer. The College of American Pathologists (CAP) developed guidelines to standardize pathology reporting; however, compliance with margin documentation guidelines has been shown to vary. The aim of this retrospective study was to determine whether compliance with CAP guidelines affects re-excision and mastectomy rates. METHODS We identified 1423 patients diagnosed with breast cancer between 1998 and 2006 who underwent BCS with negative margins. CAP compliance was categorized as maximal, minimal, or non-compliant. Statistical analyses were performed comparing the frequency of re-excision and mastectomy after initial BCS according to CAP margin reporting guideline compliance. Data were adjusted for provider facility by including a clustering variable within the regression model. RESULTS Patients with non-compliant margin reporting were 1.7 times more likely to undergo re-excision and/or mastectomy than those with maximally compliant reporting. Level of compliance was most strongly associated with the frequency of mastectomy; non-compliant margin reporting was associated with a 2.5-fold increase in mastectomy rates compared to maximally compliant reporting. The results did not substantially change when the analyses accounted for clustering at the provider facility level. CONCLUSIONS Our findings suggest that compliance with CAP guidelines in pathology reporting may be associated with variation in re-excision and mastectomy rates following BCS.
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Affiliation(s)
| | - Mairin A Jerome
- The University of Vermont College of Medicine, Burlington, VT, USA
| | - Ted A James
- The University of Vermont College of Medicine, Burlington, VT, USA; Fletcher Allen Health Care, Burlington, VT, USA
| | - Peter Callas
- The University of Vermont College of Medicine, Burlington, VT, USA
| | - John Mace
- The University of Vermont College of Medicine, Burlington, VT, USA
| | - Michelle Sowden
- The University of Vermont College of Medicine, Burlington, VT, USA; Fletcher Allen Health Care, Burlington, VT, USA
| | - Andrew Goodwin
- The University of Vermont College of Medicine, Burlington, VT, USA; Fletcher Allen Health Care, Burlington, VT, USA
| | - Donald L Weaver
- The University of Vermont College of Medicine, Burlington, VT, USA; Fletcher Allen Health Care, Burlington, VT, USA
| | - Brian L Sprague
- The University of Vermont College of Medicine, Burlington, VT, USA
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Porter KR, Chao C, Quinn VP, Hsu JWY, Jacobsen SJ. Variability in date of prostate cancer diagnosis: a comparison of cancer registry, pathology report, and electronic health data sources. Ann Epidemiol 2014; 24:855-60. [PMID: 25282324 DOI: 10.1016/j.annepidem.2014.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Revised: 09/04/2014] [Accepted: 09/10/2014] [Indexed: 11/17/2022]
Abstract
PURPOSE The date of cancer diagnosis is a critical data element for clinical care and research. Because this date can be abstracted from various data sources, its comparability from source to source is unclear. This study compared the date of diagnosis from multiple sources within the same population of prostate cancer patients. METHODS We linked cancer registry, pathology report, and electronic health data sources from the Kaiser Permanente Southern California health data systems for a cohort of 22,666 members diagnosed with prostate cancer between 2000 and 2010. The magnitude and direction of the differences in date of diagnosis were assessed for each date pairwise comparison. We reviewed 454 medical records to determine reasons for date discrepancies. RESULTS Among the date pairwise comparisons, differences in date of diagnosis spanned from 9.6 years earlier to 10 years later than each other. However, the overall median difference ranged from 1 to 16 days, thus suggesting that the vast majority of the date differences were small. Chart review results identified major categories of date discrepancies. CONCLUSIONS These data demonstrate variability in date of diagnosis across these data sources. This variability may have implications for epidemiologic estimates or patient identification in research studies using different data sources.
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Affiliation(s)
- Kimberly R Porter
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA.
| | - Chun Chao
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Virginia P Quinn
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Jin-Wen Y Hsu
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Steven J Jacobsen
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
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Landercasper J, Whitacre E, Degnim AC, Al-Hamadani M. Reasons for re-excision after lumpectomy for breast cancer: insight from the American Society of Breast Surgeons Mastery(SM) database. Ann Surg Oncol 2014; 21:3185-91. [PMID: 25047472 DOI: 10.1245/s10434-014-3905-1] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Indexed: 01/17/2023]
Abstract
BACKGROUND There is marked variability of re-excision rates after initial lumpectomy for breast cancer. Reasons for re-excision and variability across surgeons have not been well documented. We hypothesized the American Society of Breast Surgeons (ASBrS) Mastery(SM) Program can identify reasons for re-excision. METHODS Data from January 1 to 7 November 2013 were evaluated in the ASBrS Mastery(SM) Program to determine re-excision lumpectomy rate (RELR). On 1 June 2013, a tool to track reasons for re-excision was developed. Variation in re-excision rate by surgeon and patient characteristics was performed by Chi square test and Fisher's test for univariate analysis, then logistic regression with backwards elimination method for multivariate analysis. RESULTS For 6,725 patients undergoing initial lumpectomy for cancer, 328 surgeons reported 1,451 (21.6 %) patients had one or more re-excisions. The most common reasons for re-excision were ink positive margins in 783 (49.7 %), margin <1 mm (34.3 %), and margin 1-2 mm (7.2 %). By multivariate analysis, re-excision rates were lower in patients aged less than 35 years, with White (non-) Hispanic ethnicity, and, among surgeons in solo practice, more years in practice and higher-volume practice. CONCLUSION Half of re-excisions after initial lumpectomy were performed for margins that are positive. Most of the remainder were for negative close (<1-2 mm) margins. This information corroborates surgeon survey data regarding reasons for re-excision and provides proof of concept the Mastery(SM) Program can capture surgical outcome data in real time, providing opportunity and a method for future performance improvement.
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Schwartz T, Degnim AC, Landercasper J. Should Re-excision Lumpectomy Rates Be a Quality Measure in Breast-Conserving Surgery? Ann Surg Oncol 2013; 20:3180-3. [DOI: 10.1245/s10434-013-3206-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Indexed: 01/17/2023]
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Abstract
This study aims to investigate the adequacy of pathology reports of specimens from patients with differentiated thyroid cancer (DTC) operated in our institution. Retrospective analysis of the pathology reports of all patients diagnosed with DTC in our area, from 1 January 2006 through 30 June 2011, was done. Sixty-eight patients were diagnosed with DTC. All reports were descriptive. In all the reports, but one, one or more core data items (according to the Royal College of Pathologists) were missing. Information about 1 and 2 items was lacking in 7.4 and 42.6 % of the reports, respectively. The rest were missing three or more data. Lymphovascular invasion, histology subtype, and completeness of excision were, in this order, the three most frequently omitted data. Sometimes, the information in question was not explicitly expressed but could be extrapolated from the data available. The pathology reports of DTC specimens frequently miss some of the information considered necessary to provide a comprehensive patient care.
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Affiliation(s)
- Ma Luisa Isidro
- Endocrine Department, Complejo Hospitalario Universitario A Coruña, A Coruña, Spain.
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James TA, Mace JL, Virnig BA, Geller BM. Preoperative Needle Biopsy Improves the Quality of Breast Cancer Surgery. J Am Coll Surg 2012; 215:562-8. [DOI: 10.1016/j.jamcollsurg.2012.05.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Revised: 05/17/2012] [Accepted: 05/18/2012] [Indexed: 11/23/2022]
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