Confocal Microscopy for Intraoperative Margin Assessment of Lumpectomies by Surgeons in Breast Cancer: Training, Implementation in Routine Practice, and Two-Year Retrospective Analysis

Abstract

'Michel Boulvain' 'Benedetta Guani' 'Samuel Cos'] Title: Simple Summary Breast-conserving surgery is a standard approach in early-stage breast cancer, aiming to remove the tumor while preserving healthy breast tissue. A key challenge is ensuring that the margins of the removed tissue are free of cancer cells, as involved margins often lead to repeat surgery. This study evaluates the use of the Histolog Scanner, a confocal microscopy device that provides real-time imaging of the surgical specimen during an operation. One surgeon underwent a structured training program and then used the scanner routinely over a two-year period. The findings demonstrate that the device enabled an accurate intraoperative assessment of the margin status and eliminated the risk of re-excisions in this cohort. This research suggests that with appropriate training, confocal microscopy can be effectively integrated into clinical practice to improve surgical precision and reduce the burden of repeat procedures for patients undergoing breast-conserving surgery.