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. 2020 Oct 15;10:17344. doi: 10.1038/s41598-020-74373-6

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© The Author(s) 2020

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Gross intraoperative assessment workflow with example specimen. (A) Radiograph of a freshly excised breast lumpectomy specimen. (B) Excised specimen with orienting sutures and a localization wire. Dye from the sentinel node localization procedure is present. (C) The specimen has been inked in six colors to designate the surgical margins (inferior, superior, anterior, posterior, medial, lateral). (D) Representative serial sections. A centrally located tumor is visible as a vaguely defined area of whitish discoloration. (E) A close-up with the region of tumor annotated (black circle), as well as the grossly identified closest margin (red ruler). In this case the green-inked inferior margin was closest, and grossly measured 1 mm to the tumor. A SAVI SCOUT localization device is present (Cianna Medical, Inc.). (F) Microscopic pathology showing invasive ductal carcinoma. The microscopic distance to the inferior margin was 1 mm (red ruler). Gross intraoperative assessment prompted immediate re-excision of this margin, and the re-excised margin was negative for carcinoma.