Intraoperative Ultrasound Guidance in Breast-Conserving Surgery Improves Cosmetic Outcomes and Patient Satisfaction: Results of a Multicenter Randomized Controlled Trial (COBALT)

• DOI: 10.1245/s10434-015-4906-4
• Publication Date: 2015-10-21T19:36:15Z
• Authors: Max H. Haloua; José H. Volders; Nicole M. A. Krekel; Alexander M. F. L...; Wifred K. de Roos; Louise M. de Widt...; Henk van der Veen; Herman Rijna; Elisabeth Bergers; Katarzyna Jóźwiak; Sybren Meijer; M. Petrousjka van...
• Keywords: Surgical oncology

Ultrasound-guided breast-conserving surgery (USS) results in a significant reduction both margin involvement and excision volumes (COBALT trial). The aim of the present study was to determine whether USS also leads improvements cosmetic outcome patient satisfaction when compared with standard palpation-guided (PGS). A total 134 patients T1–T2 invasive breast cancer were included COBALT trial (NTR2579) randomized either (65 patients) or PGS (69 patients). Cosmetic outcomes assessed by three-member panel using computerized software Breast Cancer Conservative Treatment (BCCT.core) self-evaluation, including satisfaction. Time points for follow-up 3, 6, 12 months after surgery. Overall scored on 4-point Likert scale (excellent, good, fair, poor), analyzed multilevel, mixed effect, proportional odds model ordinal responses. achieved better outcomes, 20 % excellence overall only 6 rated as poor, whereas 14 excellent 13 poor. had consistently lower worse (odds ratio 0.55, p = 0.067) than PGS. chance having significantly increased larger lumpectomy volume (p trend 0.002); >40 cc showed 2.78-fold higher ≤40 cc. resulted Lumpectomy outcomes.