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Radioactive seed localization is the preferred technique in nonpalpable breast cancer compared with wire-guided localization and radioguided occult lesion localization

Theunissen, Carla I.J.M.; Rust, Esther A.Z.; Edens, Mireille A.; Bandel, Caroline; van’t Ooster-van den Berg, Janneke G.; Jager, Piet L.; Noorda, Eva M.; Francken, Anne Brecht

Nuclear Medicine Communications: May 2017 - Volume 38 - Issue 5 - p 396–401
doi: 10.1097/MNM.0000000000000659
ORIGINAL ARTICLES
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Objectives Three commonly used techniques for localization of nonpalpable breast cancer are radioactive seed localization (RSL), wire-guided localization (WGL) and radioguided occult lesion localization (ROLL). In this study, we analysed the surgical margins of these three techniques.

Methods Women diagnosed with nonpalpable breast cancer undergoing breast-conserving surgery with one of the above-mentioned techniques were retrospectively included. The primary outcome parameter was tumour-free margin rate. Secondary outcomes were re-excision rate, recurrence of disease and volume of removed tissue.

Results In total, 272 women were included in whom RSL (n=69), WGL (n=76) or ROLL (n=137) was performed. RSL showed a higher tumour-free margin rate [64 (92.8%)] compared with WGL [51 (67.1%)] and ROLL [113 (82.5%)] (P=0.001). In our multivariable analysis, RSL showed a higher tumour-free margin rate as well compared with WGL (P=0.036) and ROLL (P=0.049). Also, fewer re-excisions were encountered using RSL [5 (7.2%)] compared with WGL [13 (17.1%)] and ROLL [15 (10.9%)] (P=0.171). In 11 patients (WGL n=2, ROLL n=9), recurrence of disease occurred, despite a radical excision. The mean resection volumes were comparable within the three groups.

Conclusion RSL results in a higher tumour-free margin rate in nonpalpable breast tumours compared with WGL and ROLL. Therefore, we prefer using RSL in nonpalpable breast tumours.

Departments of aPlastic Surgery

bInnovation and Science

cSurgery

dNuclear Medicine, Isala, Zwolle, The Netherlands

Correspondence to Carla I.J.M. Theunissen, MD, Department of Plastic Surgery, Isala, Dr. van Heesweg 2, 8025 AB Zwolle, The Netherlands Tel: +31 384 245 000; fax: +31 384 247 667; e-mail: c.i.j.m.theunissen@isala.nl

Received December 26, 2016

Accepted February 28, 2017

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