Dr. Kandace P. McGuire shares how 3D tomosynthesis assisted her during two cases (The Case of the Missing Magseed & Imaging a Bracketed Lesion). In addition, Dr. McGuire discusses how she evaluated the specimens in multiple ways using KUBTEC’s MOZART System.

‍

"It’s a great instrument for specimen radiography. The Mozart System helped me, and my team determine what we need to do next in the case”‍ - Kandace P. McGuire, MD

‍

Case 1: The Case of Missing Magseed

• 53-year-old female diagnosed with right breast cancer on imaging. Hx of prior benign biopsy in right breast
• OB Hx: Menarche at age 14, Menopause at age50, G6P2, age at first live birth 38, OCP’s x 16 years, HRT x 0 years, did breastfeed.
• FmHx: Breast cancer, melanoma
• History & PE otherwise unremarkable

‍

Case 2: Imaging a Bracketed Lesion

• 76-year-old female with L breast DCIS detected on screen mammogram. She denies any breast complaints. No history of prior biopsies or abnormal mammograms. G1P1, age at birth 27, menarche age 12, menopause, No OCP’s, HRT x 31 years
• PMHx/PSHx- Non-Contributory
• No T/E/D
• PE- No significant findings, normal breast exam

‍

‍Lessons Learned

• Always listen for Magseed AFTER removal of the specimen
• Intraoperative imaging allows for rapid identification of missing clips, seeds, close margins, etc.
• KUBTEC ‘slices’ allow for assessment of all six margins with one image –no need for orthogonal imaging
• Intraoperative specimen radiograph shortens surgery time
• In the case of cavity shave margins, can customize margin thickness and it is easier to interpret bracketed lesions in three dimensions

‍

‍

Surgeon Biography:

Dr. Kandace P. McGuire, is a Professor of Surgery, Chief of Breast Surgery and Director of Breast Oncology Clinic, Associate Medical Director of the Cancer Service Line, Massey Cancer Center, Virginia Commonwealth University. Dr. McGuire is a graduate of Eastern Virginia Medical School and joined VCU in 2017.