Redefining Margin Assessment in Breast Conservation Surgery: Surgeon-Performed Intraoperative Ultrasound as a Reliable Alternative to Radiologic and Mammographic Assessment

Surgeon-performed IOSpUS provides real-time, workflow-efficient intraoperative margin assessment, with diagnostic performance comparable to that of radiologist-performed ultrasound and specimen mammography in this prospective cohort. In low-resource environments, gross examination, though less sensitive, remains a viable adjunct when imaging facilities are limited. A combined approach has the potential to reduce re-excision by supporting intraoperative decision-making.