Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 2/2013

01-07-2013 | Review

Systematic review of radioguided versus wire-guided localization in the treatment of non-palpable breast cancers

Authors: Muneer Ahmed, Mieke van Hemelrijck, Michael Douek

Published in: Breast Cancer Research and Treatment | Issue 2/2013

Login to get access

Abstract

One-third of breast cancers present as non-palpable lesions. The current gold standard treatment for these cancers is localized wide local excision using wire-guided localization (WGL). WGL has drawbacks including technical and scheduling issues resulting in the development of alternative radioguided techniques (RGL). A systematic review was performed to identify studies comparing RGL and WGL. The outcomes of surgical margin status, re-operation rates, surgical operative time, volume and excised specimen weight and successful sentinel lymph node biopsy (SLNB) rates were evaluated. Pooled odds ratios (ORs) and 95 % confidence intervals were estimated using fixed-effects analyses and random-effects analyses in case of statistically significant heterogeneity (p < 0.05). Seven randomized controlled trials (RCTs) matching the inclusion criteria were identified. The pooled ORs for involved surgical margin status were 0.78 (95 % CI, 0.52–1.17); for re-operations 0.74 (95 % CI, 0.49–1.11) and for successful SLNB 1.29 (95 % CI, 0.66–2.53). There was a significant difference in surgical operating time in favour of RGL (mean difference (MD), −2.95; 95 % CI, −4.43, −1.47) and a significant difference in excised specimen volume, favouring WGL (MD, 6.79; 95 % CI, 0.03, 13.56). The MD for a specimen weight of −3.00 (95 % CI, −15.15, 9.15) showed no significant difference between RGL and WGL. RGL has a reduced operating time, but larger volume excisions compared to WGL. There is insufficient evidence to support the uptake of RGL over WGL, and larger, adequately powered, multi-centre RCTs are required.
Literature
1.
Lovrics PJ, Cornacchi SD, Farrokhyar F, Garnett A, Chen V, Franic S, Simunovic M (2009) The relationship between surgical factors and margin status after breast-conservation surgery for early stage breast cancer. Am J Surg 197(6):740–746PubMedCrossRef
2.
Luini A, Zurrida S, Paganelli G, Galimberti V, Sacchini V, Monti S, Veronesi P, Viale G, Veronesi U (1999) Comparison of radioguided excision with wire localization of occult breast lesions. Brit J Surg 86(4):522–525PubMedCrossRef
3.
Ocal K, Dag A, Turkmenoglu O, Gunay EC, Yucel E, Duce MN (2011) Radioguided occult lesion localization versus wire-guided localization for non-palpable breast lesions: randomized controlled trial. Clinics 66(6):1003–1007PubMedCrossRef
4.
Rampaul RS, Bagnall M, Burrell H, Pinder SE, Evans AJ, Macmillan RD (2004) Randomized clinical trial comparing radioisotope occult lesion localization and wire-guided excision for biopsy of occult breast lesions. Brit J Surg 91(12):1575–1577PubMedCrossRef
5.
The Nordic Cochrane Centre CC (2008) Review Manager (RevMan) [Computer program]. Version 5.0. In.
6.
Hozo SP, Djulbegovic B, Hozo I (2005) Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol 5:13PubMedCrossRef
7.
Higgins JPT Green S (eds) (2008) Cochrane handbook for systematic reviews of interventions version 5.0.0 (updated February 2008): The Cochrane Collaboration 2008
8.
Demets DL (1987) Methods for combining randomized clinical trials: strengths and limitations. Stat Med 6(3):341–350PubMedCrossRef
9.
10.
Higgins JP, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21(11):1539–1558PubMedCrossRef
11.
Lovrics PJ, Goldsmith CH, Hodgson N, McCready D, Gohla G, Boylan C, Cornacchi S, Reedijk M (2011) A multicentered, randomized, controlled trial comparing radioguided seed localization to standard wire localization for nonpalpable, invasive and in situ breast carcinomas. Ann Surg Oncol 18(12):3407–3414PubMedCrossRef
12.
Mariscal Martinez A, Sola M, de Tudela AP, Julian JF, Fraile M, Vizcaya S, Fernandez J (2009) Radioguided localization of nonpalpable breast cancer lesions: randomized comparison with wire localization in patients undergoing conservative surgery and sentinel node biopsy. Am J Roentgenol 193(4):1001–1009CrossRef
13.
Medina-Franco H, Abarca-Perez L, Garcia-Alvarez MN, Ulloa-Gomez JL, Romero-Trejo C, Sepulveda-Mendez J (2008) Radioguided occult lesion localization (ROLL) versus wire-guided lumpectomy for non-palpable breast lesions: a randomized prospective evaluation. J Surg Oncol 97(2):108–111PubMedCrossRef
14.
Moreno M, Wiltgen JE, Bodanese B, Schmitt RL, Gutfilen B, da Fonseca LM (2008) Radioguided breast surgery for occult lesion localization—correlation between two methods. J Exp Clin Cancer Res: CR 27:29PubMedCrossRef
15.
Postma EL, Verkooijen HM, van Esser S, Hobbelink MG, van der Schelling GP, Koelemij R, Witkamp AJ, Contant C, van Diest PJ, Willems SM et al (2012) Efficacy of ‘radioguided occult lesion localisation’ (ROLL) versus ‘wire-guided localisation’ (WGL) in breast conserving surgery for non-palpable breast cancer: a randomised controlled multicentre trial. Breast Cancer Res Treat 136(2):469–478PubMedCrossRef
16.
Lovrics PJ, Cornacchi SD, Vora R, Goldsmith CH, Kahnamoui K (2011) Systematic review of radioguided surgery for non-palpable breast cancer. Eur J Surg Oncol: J Eur Soc Surg Oncol Brit Assoc Surg Oncol 37(5):388–397CrossRef
17.
Sajid MS, Parampalli U, Haider Z, Bonomi R (2012) Comparison of radioguided occult lesion localization (ROLL) and wire localization for non-palpable breast cancers: a meta-analysis. J Surg Oncol 105(8):852–858PubMedCrossRef
18.
Ahmed M (2013) Significance of the volume of excised specimens in radio guided occult lesion localization (ROLL). J Surg Oncol 107(8):874
19.
Cochrane RA, Valasiadou P, Wilson AR, Al-Ghazal SK, Macmillan RD (2003) Cosmesis and satisfaction after breast-conserving surgery correlates with the percentage of breast volume excised. Brit J Surg 90(12):1505–1509PubMedCrossRef
20.
Taylor ME, Perez CA, Halverson KJ, Kuske RR, Philpott GW, Garcia DM, Mortimer JE, Myerson RJ, Radford D, Rush C (1995) Factors influencing cosmetic results after conservation therapy for breast cancer. Int J Radiat Oncol Biol Phys 31(4):753–764PubMedCrossRef
21.
Vrieling C, Collette L, Fourquet A, Hoogenraad WJ, Horiot JH, Jager JJ, Pierart M, Poortmans PM, Struikmans H, Maat B et al (2000) The influence of patient, tumor and treatment factors on the cosmetic results after breast-conserving therapy in the EORTC ‘boost vs. no boost’ trial. EORTC Radiotherapy and Breast Cancer Cooperative Groups. Radiother Oncol J Eur Soc Therap Radiol Oncol 55(3):219–232CrossRef
22.
Clough KB, Lewis JS, Couturaud B, Fitoussi A, Nos C, Falcou MC (2003) Oncoplastic techniques allow extensive resections for breast-conserving therapy of breast carcinomas. Ann Surg 237(1):26–34PubMedCrossRef
23.
Petit JY, Garusi C, Greuse M, Rietiens M, Youssef O, Luini A, De Lorenzi F (2002) One hundred and eleven cases of breast conservation treatment with simultaneous reconstruction at the European Institute of Oncology (Milan). Tumori 88(1):41–47PubMed
24.
Woerdeman LAE, Hage JJ, Thio EA, Zoetmulder FAN, Th. Rutgers EJ (2004) Breast-conserving therapy in patients with a relatively large (T2 or T3) breast cancer: long-term local control and cosmetic outcome of a feasibility study. Plast Reconstr Surg 113(6):1607–1616PubMedCrossRef
25.
Veronesi U, Luini A, Botteri E, Zurrida S, Monti S, Galimberti V, Cassano E, Latronico A, Pizzamiglio M, Viale G et al (2010) Nonpalpable breast carcinomas: long-term evaluation of 1,258 cases. Oncologist 15(12):1248–1252PubMedCrossRef
26.
Postma EL, Koffijberg H, Verkooijen HM, Witkamp AJ, van den Bosch MA, van Hillegersberg R (2013) Cost-Effectiveness of Radioguided Occult Lesion Localization (ROLL) Versus Wire-Guided Localization (WGL) in breast conserving surgery for nonpalpable breast cancer: results from a randomized controlled multicenter trial. Ann Surg Oncol
27.
Rao R, Moldrem A, Sarode V, White J, Amen M, Rao M, Andrews V, Euhus D, Radford L, Ulissey M (2010) Experience with seed localization for nonpalpable breast lesions in a public health care system. Ann Surg Oncol 17(12):3241–3246PubMedCrossRef
28.
Haigh PI, Glass EC, Essner R (2000) Accuracy of gamma probes in localizing radioactivity: in vitro assessment and clinical implications. Cancer Biother Radiopharm 15(6):561–569PubMedCrossRef
29.
Britton TB, Solanki CK, Pinder SE, Mortimer PS, Peters AM, Purushotham AD (2009) Lymphatic drainage pathways of the breast and the upper limb. Nucl Med Commun 30(6):427–430PubMedCrossRef
30.
Bernardi S, Bertozzi S, Londero AP, Gentile G, Giacomuzzi F, Carbone A (2012) Incidence and risk factors of the intraoperative localization failure of nonpalpable breast lesions by radio-guided occult lesion localization: a retrospective analysis of 579 cases. World J Surg 36(8):1915–1921PubMedCrossRef
31.
Gray RJ, Pockaj BA, Karstaedt PJ, Roarke MC (2004) Radioactive seed localization of nonpalpable breast lesions is better than wire localization. Am J Surg 188(4):377–380PubMedCrossRef
32.
Gray RJ, Salud C, Nguyen K, Dauway E, Friedland J, Berman C, Peltz E, Whitehead G, Cox CE (2001) Randomized prospective evaluation of a novel technique for biopsy or lumpectomy of nonpalpable breast lesions: radioactive seed versus wire localization. Ann Surg Oncol 8(9):711–715PubMedCrossRef
33.
Hughes JH, Mason MC, Gray RJ, McLaughlin SA, Degnim AC, Fulmer JT, Pockaj BA, Karstaedt PJ, Roarke MC (2008) A multi-site validation trial of radioactive seed localization as an alternative to wire localization. Breast J 14(2):153–157PubMedCrossRef
34.
McGhan LJ, McKeever SC, Pockaj BA, Wasif N, Giurescu ME, Walton HA, Gray RJ (2011) Radioactive seed localization for nonpalpable breast lesions: review of 1,000 consecutive procedures at a single institution. Ann Surg Oncol 18(11):3096–3101PubMedCrossRef
35.
Gobardhan PD, de Wall LL, van der Laan L, ten Tije AJ, van der Meer DC, Tetteroo E, Poortmans PM, Luiten EJ (2013) The role of radioactive iodine-125 seed localization in breast-conserving therapy following neoadjuvant chemotherapy. Ann Oncol Off J Eur Soc Med Oncol/ESMO 24(3):668–673CrossRef
36.
Wendler T, Herrmann K, Schnelzer A, Lasser T, Traub J, Kutter O, Ehlerding A, Scheidhauer K, Schuster T, Kiechle M et al (2010) First demonstration of 3-D lymphatic mapping in breast cancer using freehand SPECT. Eur J Nucl Med Mol Imaging 37(8):1452–1461PubMedCrossRef
37.
Blumel C, Wendler T, Schnelzer A, Scheidhauer K (2012) Improvements in sentinel lymph node biopsy of breast cancer using freehand SPECT. In:Proceedings of the international sentinel node society meeting, Amsterdam, Netherlands
38.
Brouwer O, van der Hage J, Valdes Olmos R (2013) Feasibility of 3D intraoperative SPECT probe imagaing for radioguided tumour excision and sentinel node biopsy in breast cancer. Universiteit van Amsterdam
Metadata
Title
Systematic review of radioguided versus wire-guided localization in the treatment of non-palpable breast cancers
Authors
Muneer Ahmed
Mieke van Hemelrijck
Michael Douek
Publication date
01-07-2013
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 2/2013
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-013-2547-5

Other articles of this Issue 2/2013

Breast Cancer Research and Treatment 2/2013 Go to the issue

Preclinical study

Comparison of efficacy of 95-gene and 21-gene classifier (Oncotype DX) for prediction of recurrence in ER-positive and node-negative breast cancer patients

Preclinical study

The oestrogen receptor coactivator CARM1 has an oncogenic effect and is associated with poor prognosis in breast cancer

Preclinical study

Exosomal pMHC-I complex targets T cell-based vaccine to directly stimulate CTL responses leading to antitumor immunity in transgenic FVBneuN and HLA-A2/HER2 mice and eradicating trastuzumab-resistant tumor in athymic nude mice

Clinical trial

Eribulin mesylate versus ixabepilone in patients with metastatic breast cancer: a randomized Phase II study comparing the incidence of peripheral neuropathy

Preclinical Study

Molecular imaging with a fluorescent antibody targeting carbonic anhydrase IX can successfully detect hypoxic ductal carcinoma in situ of the breast

Review

Five or more years of adjuvant endocrine therapy in breast cancer: a meta-analysis of published randomised trials
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits