Systematic review and meta-analysis of the impact of intra-operative ultrasound guided breast-conserving surgery in early breast cancer. Background: Breast Conservation (BCS) is the standard surgical procedure for early breast cancer. It is challenging for surgeons to achieve adequate excision of the lesion with clear margins and acceptable cosmesis. A continuous Intra-Operative Ultrasound (IOUS) is used during BCS in volume precision surgery. We reviewed its effectiveness to obtain clear margins, low excision volume and better cosmetic outcome during BCS. Methods: We searched three bibliographic databases (MEDLINE, CINAHL, Cochrane Library online) for relevant published and unpublished literature from their inception until December 2019. The randomized controlled trials of the impact of IOUS on excision volume, margin status and cosmetic outcome was assessed, and meta-analysis carried out for margin status with narrative summary was done for other results. Results: This study included four articles in the systematic review. A total of 207 patients with IOUS and 192 patients with Palpation Guided (PGS) BCS was studied in this review. The standardised mean difference of excision
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