Radioactive seed localization compared to wire localization in breast-conserving surgery: Initial 6-month experience Journal Article


Authors: Murphy, J. O.; Moo, T. A.; King, T. A.; Van Zee, K. J.; Villegas, K. A.; Stempel, M.; Eaton, A.; St Germain, J. M.; Morris, E.; Morrow, M.
Article Title: Radioactive seed localization compared to wire localization in breast-conserving surgery: Initial 6-month experience
Abstract: Background. Wire localization (WL) of nonpalpable breast cancers on the day of surgery is uncomfortable for patients and impacts operating room efficiency. Radioactive seed localization (RSL) before the day of surgery avoids these disadvantages. In this study we compare outcomes of our initial 6-month experience with RSL to those with WL in the preceding 6 months. Methods. Lumpectomies for invasive or intraductal cancers localized with a single 125 iodine seed (January-June 2012) were compared with those using 1 wire (July-December 2011). Surgeons and radiologists did not change. Positive and close margins were defined as tumor on ink and tumor <= 1 mm from ink, respectively. Demographic and clinical characteristics and outcomes were compared between RSL and WL patients. Results. There were 431 RSL and 256 WL lumpectomies performed. Clinicopathologic characteristics did not differ between groups. Most seeds (90 %) were placed before the day of surgery. Positive margins were present in 7.7 % of RSL versus 5.5 % of WL patients, and 16.9 % of RSL versus 19.9 % of WL had close margins (p = 0.38). The median operative time was longer for lumpectomy and sentinel lymph node biopsy (SLNB) in the RSL group (55 vs. 48 min, p < 0.0001). There was no significant difference in the volume of tissue excised between groups. Conclusions. In the first 6 months of RSL, operative scheduling was simplified, while rates of positive and close margins were similar to those seen after many years of experience with WL. Operative time was slightly longer for RSL lumpectomy and SLNB; we anticipate this will decrease with experience.
Keywords: safety; trial; cancer; occult lesion localization; node biopsy snoll
Journal Title: Annals of Surgical Oncology
Volume: 20
Issue: 13
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2013-12-01
Start Page: 4121
End Page: 4127
Language: English
ACCESSION: WOS:000328256600013
DOI: 10.1245/s10434-013-3166-4
PROVIDER: wos
PUBMED: 23943024
PMCID: PMC4003499
Notes: Article -- Source: Wos
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MSK Authors
  1. Monica Morrow
    777 Morrow
  2. Kimberly J Van Zee
    293 Van Zee
  3. Elizabeth A Morris
    342 Morris
  4. Tari King
    186 King
  5. Anne Austin Eaton
    122 Eaton
  6. Michelle Moccio Stempel
    153 Stempel
  7. James Oliver Murphy
    7 Murphy
  8. Tracy-Ann Moo
    99 Moo