Breast Cancer Surgical Specimens: A Marking Challenge and a Novel Solution – A Prospective, Randomized Study

Background: Accurate orientation of resected breast specimens is crucial for proper pathological evaluation and reliable margin assessment. Misorientation can compromise margin analysis, potentially leading to imprecise re-excisions and increasing the risk of local recurrence. This study aims to evaluate a new specimen plate designed to maintain consistent tissue orientation and compare its effectiveness with traditional suture marking techniques. Methods: A single-center, prospective, randomized two-arm trial compared the efficacy of the novel specimen plate (n=56) with conventional suture marking (n=54) during pathological examinations. The study assessed the impact on specimen handling, intraoperative imaging interpretation, and pathological outcomes, focusing on orientation clarity, margin assessment, and ease of tissue evaluation. Results: The specimen plate demonstrated superior performance in maintaining clear orientation during intraoperative imaging and facilitated accurate margin assessment, significantly lowering (p<0.01) misorientation rate compared to suture marking. Pathologists reported improved ease at identifying direction and extent of tumor-free zones and enhanced diagnostic accuracy. Number of non-R0 resections requiring re-excisions was significantly lower in the specimen plate group in comparation with the suture markings (8,9% vs. 22,2%) indicating the former’s potential to improve surgical outcomes. Conclusions: The novel specimen plate offers a reliable solution for improving specimen orientation in breast cancer surgery. By ensuring consistent orientation and enhancing diagnostic clarity, it can contribute to better surgical accuracy, reduce re-excisions, and ultimately improve patient safety. These findings support the specimen plate as an effective tool for enhancing outcomes in breast cancer treatment.