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01-12-2013 | Breast Oncology

Radioactive Seed Localization Compared to Wire Localization in Breast-Conserving Surgery: Initial 6-Month Experience

Authors: James O. Murphy, MD, Tracy-Ann Moo, MD, Tari A. King, MD, Kimberly J. Van Zee, MS, MD, Kristine A. Villegas, BS, Michelle Stempel, MPH, Anne Eaton, MS, Jean M. St. Germain, MS, Elizabeth Morris, MD, Monica Morrow, MD

Published in: Annals of Surgical Oncology | Issue 13/2013

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 ¹²⁵iodine 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.

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Title: Radioactive Seed Localization Compared to Wire Localization in Breast-Conserving Surgery: Initial 6-Month Experience
Authors: James O. Murphy, MD
Tracy-Ann Moo, MD
Tari A. King, MD
Kimberly J. Van Zee, MS, MD
Kristine A. Villegas, BS
Michelle Stempel, MPH
Anne Eaton, MS
Jean M. St. Germain, MS
Elizabeth Morris, MD
Monica Morrow, MD
Publication date: 01-12-2013
Publisher: Springer US
Published in: Annals of Surgical Oncology / Issue 13/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-013-3166-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Radioactive Seed Localization Compared to Wire Localization in Breast-Conserving Surgery: Initial 6-Month Experience

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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