Background:Breast-conserving surgery (BCS) is recommended for early-stage breast cancer, with the aim of removing tumors while preserving breast tissue. Achieving clear margins is crucial to minimizing re-excision and recurrence risks. The Histolog®Scanner (HS), a confocal laser microscopy device, enables real-time intraoperative margin assessments. This study describes surgeon training, HS integration into clinical practice, and its impact on surgical outcomes.Methods:One surgeon participated in an online training program related to Histolog image of breast tissue. We assessed the time and workload required for the surgeon’s training, as well as the implementation of the HS into the surgical workflow. We retrospectively analyzed patients who underwent BCS with an intraoperative margin assessment performed by the trained surgeon using HS between December 2022 and January 2025. The re-excision rate was collected, and sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were calculated using the final pathology assessment as the gold standard.Results:The surgeon completed the online training in 6 h 22 min over six days. HS integration into the routine workflow occurred smoothly. Retrospective analysis included 68 consecutive patients representing two years of clinical practice. The surgeon using the HS exhibited a sensitivity of 100%, specificity of 96.3%, accuracy of 96.9%, PPV of 85.7%, and NPV of 100%. Intraoperative HS usage eliminated re-excision in all cases. Integrating the HS into routine BCS procedures provides a highly accurate intraoperative margin assessment and significant reduction of re-excision rates.
背景：对于早期乳腺癌，推荐采用保乳手术（BCS），其目标是在切除肿瘤的同时保留乳腺组织。获得清晰切缘对于降低再次切除和复发风险至关重要。Histolog®Scanner（HS）是一种共聚焦激光显微镜设备，能够实现术中切缘的实时评估。本研究描述了外科医生的培训过程、HS在临床实践中的整合应用及其对手术结果的影响。 方法：一名外科医生参加了关于乳腺组织Histolog图像的在线培训项目。我们评估了该医生培训所需的时间和工作量，以及HS在手术流程中的实施情况。我们回顾性分析了2022年12月至2025年1月期间，由经过培训的外科医生使用HS进行术中切缘评估并接受BCS的患者。收集再次切除率，并以最终病理学评估为金标准，计算敏感性、特异性、准确性、阳性预测值（PPV）和阴性预测值（NPV）。 结果：该外科医生在六天内完成了总计6小时22分钟的在线培训。HS顺利整合到常规工作流程中。回顾性分析纳入了连续68例患者，代表了两年的临床实践。使用HS的外科医生表现出100%的敏感性、96.3%的特异性、96.9%的准确性、85.7%的PPV和100%的NPV。术中HS的使用在所有病例中均避免了再次切除。将HS整合到常规BCS手术中，提供了高度准确的术中切缘评估，并显著降低了再次切除率。
肿瘤(癌症)患者之家