ObjectiveTo evaluate the efficacy of intraoperative ultrasound in obtaining adequate surgical margins in women undergoing lumpectomy for palpable breast cancer. Summary Background DataAdequacy of surgical margins is a subject of debate in the literature for women undergoing breast-conserving therapy. The emerging technology of intraoperative ultrasound-guided surgery lends itself well to a prospective study evaluating surgical accuracy and margin status after lumpectomy. MethodsTwo groups of women undergoing lumpectomy for palpable breast cancer were studied, one group using intraoperative ultrasound (n ϭ 27) and the other without (n ϭ 24). Pathologic specimens were evaluated for size, margins, and accuracy, and patients were questioned about satisfaction with cosmetic results. ResultsSurgical accuracy was improved with intraoperative ultrasound-guided surgery. Margin status was improved, patient satisfaction was equivalent, and cost was not affected using ultrasound technology. Intraoperative ultrasound appears especially efficacious for women whose preoperative mammogram shows dense parenchyma surrounding the lesion. ConclusionsThe use of ultrasound-guided surgery optimizes the surgeon's ability to obtain satisfactory margins for breast-conserving techniques in patients with breast cancer. Patient satisfaction is excellent and a cost savings is most likely realized.Although A-mode or non-real-time B-mode ultrasound imaging started in the 1960s, it was of limited clinical utility. With the introduction of high-frequency real-time B-mode ultrasound in the late 1970s, the surgeon could use ultrasound to guide surgical procedures. Special intraoperative probes were developed, and in the 1980s intraoperative ultrasound (IOUS) was developed for hepatobiliary surgery, neurosurgery, and vascular surgery.1 Breast surgeons were quick to begin using office-based ultrasound for defining breast lesions and guiding needle biopsy of ultrasound-visible lesions, but the transfer of this technology to the surgical suite for breast procedures has been a recent phenomenon.Breast-conserving therapy (BCT) has gained wide acceptance as providing long-term survival equal to that seen with mastectomy for early-stage breast cancers, and accordingly the number of lumpectomy procedures has increased dramatically. Too often, however, the surgeon is disappointed to discover that a lumpectomy performed for a small palpable tumor fails to achieve a complete excision with histopathologically negative margins. The patient may then undergo a second resection with the goal of obtaining clear pathologic margins. This recommendation for reexcision often occurs even as conflicting data are published about the need for such margins to be completely free of malignancy.

If there is going to be a future for the philosophy of religion, it is going to have to emerge out of and speak into a set of contested disciplinary, institutional, and ideological spaces as their boundaries are in the process of being renegotiated. In the first instance, philosophy of religion has traditionally been located somewhere among the disciplines of philosophy, theology, and religion, but each of these fields is undergoing transformation to which philosophy of religion must respond. At the same time, accreditation standards are requiring humanities disciplines to shift their pedagogical practices even as the commodification of higher education culturally and institutionally calls into question the value of humanistic formation. This paper outlines the points of tension that put pressure on philosophy of religion and suggests ways in which the subdiscipline might understand and locate itself at the heart of liberal and general education in the future.

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While the study of Confucianism has been ongoing in the United States for quite some time, the idea of its viability in the American context is quite recent. Even more recent are experimental attempts to practice Confucianism in the U.S. This article chronicles several such attempts and considers what demographic data there are, and their frameworks of measurement, of Confucianism in the U.S. It focuses on a case study of debates and conversations about what it means for Confucianism to be “portable” among a small but committed second generation of Boston Confucians. From quiet-sitting meditation, to textual studies and interpretation, to ritual veneration of Confucius and ancestors, this article is one of the first empirical studies of Confucianism as a lived tradition in the United States. It situates these practices, and descriptions, discussions, and debates about them by their enactors, in the context of the Protestantized religious landscape in the U.S. It also considers how Confucianism has registered in unexpected ways in the U.S. context amidst the COVID-19 pandemic. Confucianism in the U.S. emerges as a form of way-making, irreducible to the categories of philosophy or religion, that both reflects and transforms its inheritance of Confucianism from East Asia.