Efficacy of mammography in assessing safety margin on surgical specimens

Objectives: This study evaluates the efficacy of mammography in assessing surgical margins in breast cancer patients undergoing breast-conserving surgery (BCS) to minimize reoperation rates. By comparing radiologic assessments with histopathology results, we assess mammography’s sensitivity, specificity, and diagnostic performance in determining margin status. Methods: A retrospective analysis was conducted on patients who underwent BCS at Prince Sultan Military Medical City between 2021 and 2023. Radiology assessments from mammography were compared with pathology results to calculate sensitivity, specificity, and the rates of false positives and false negatives. Results: The study found a sensitivity of 84%, indicating that mammography successfully identified 84% of cases with positive margins. Specificity was 81.6%, with a false positive rate of 18.4% and a false negative rate of 16%. These findings suggest that mammography provides reasonable accuracy for intraoperative margin assessment, although the presence of false positives and false negatives highlights the need for further optimization. Conclusion: While mammography offers a relatively effective method for intraoperative margin assessment, improvements are needed to reduce the rates of false positives and false negatives. Advanced imaging technologies, such as digital breast tomosynthesis, may enhance the precision of margin assessments.