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A multicentered, randomized, controlled trial comparing radioguided seed localization to standard wire localization for nonpalpable, invasive and in situ breast carcinomas.
Ann Surg Oncol 2011; 18(12):3407-14AS

Abstract

BACKGROUND

Studies suggest radioguided seed localization (RSL) yields fewer positive margins than wire-guided localization (WL). The goal of this study is to determine whether RSL is superior to WL.

METHODS

Women with confirmed invasive or ductal carcinoma in situ (DCIS) undergoing localization and breast conserving surgery were enrolled. Outcomes measured include positive margin and reoperation rates, specimen weight, operative and localization times, and surgeon and radiologist ranking of procedural difficulty.

RESULTS

Randomization was centralized, concealed, and stratified by surgeon with 153 patients in the WL group and 152 in RSL group. Localizations were performed using either ultrasound (70%) or mammographic guidance (30%). Pathology was either DCIS (18%) or invasive carcinoma (82%). Procedures were performed at 3 sites, by 7 surgeons. Only difference found for patient and tumor characteristics was more multifocal disease in RSL group. Using intention-to-treat analysis, there were no differences in positive margins rates for RSL (10.5%) and WL (11.8%), (P=.99) or for positive or close margins (<1 mm) (RSL 19% and WL 22%; P=.61). Mean operative time (minutes) was shorter for RSL (RSL 19.4 vs WL 22.2; P<.001). Specimen volume, weight, reoperation and localization times were similar. Surgeons ranked the seed technique as easier (P=.008), while radiologists ranked them similarly. Patient's pain rankings during wire localization were higher (P=.038).

CONCLUSIONS

In contrast to other trials positive margin and reoperation rates were similar for RSL and WL. However, for RSL operative times were shorter, and the technique was preferred by surgeons, making it an acceptable method for localization.

Authors+Show Affiliations

Department of Surgery, McMaster University, and St. Joseph's Healthcare, Hamilton, ON, Canada. lovricsp@mcmaster.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21533657

Citation

Lovrics, Peter J., et al. "A Multicentered, Randomized, Controlled Trial Comparing Radioguided Seed Localization to Standard Wire Localization for Nonpalpable, Invasive and in Situ Breast Carcinomas." Annals of Surgical Oncology, vol. 18, no. 12, 2011, pp. 3407-14.
Lovrics PJ, Goldsmith CH, Hodgson N, et al. A multicentered, randomized, controlled trial comparing radioguided seed localization to standard wire localization for nonpalpable, invasive and in situ breast carcinomas. Ann Surg Oncol. 2011;18(12):3407-14.
Lovrics, P. J., Goldsmith, C. H., Hodgson, N., McCready, D., Gohla, G., Boylan, C., ... Reedijk, M. (2011). A multicentered, randomized, controlled trial comparing radioguided seed localization to standard wire localization for nonpalpable, invasive and in situ breast carcinomas. Annals of Surgical Oncology, 18(12), pp. 3407-14. doi:10.1245/s10434-011-1699-y.
Lovrics PJ, et al. A Multicentered, Randomized, Controlled Trial Comparing Radioguided Seed Localization to Standard Wire Localization for Nonpalpable, Invasive and in Situ Breast Carcinomas. Ann Surg Oncol. 2011;18(12):3407-14. PubMed PMID: 21533657.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A multicentered, randomized, controlled trial comparing radioguided seed localization to standard wire localization for nonpalpable, invasive and in situ breast carcinomas. AU - Lovrics,Peter J, AU - Goldsmith,Charlie H, AU - Hodgson,Nicole, AU - McCready,David, AU - Gohla,Gabriela, AU - Boylan,Colm, AU - Cornacchi,Sylvie, AU - Reedijk,Michael, Y1 - 2011/04/30/ PY - 2010/12/23/received PY - 2011/5/3/entrez PY - 2011/5/3/pubmed PY - 2012/2/9/medline SP - 3407 EP - 14 JF - Annals of surgical oncology JO - Ann. Surg. Oncol. VL - 18 IS - 12 N2 - BACKGROUND: Studies suggest radioguided seed localization (RSL) yields fewer positive margins than wire-guided localization (WL). The goal of this study is to determine whether RSL is superior to WL. METHODS: Women with confirmed invasive or ductal carcinoma in situ (DCIS) undergoing localization and breast conserving surgery were enrolled. Outcomes measured include positive margin and reoperation rates, specimen weight, operative and localization times, and surgeon and radiologist ranking of procedural difficulty. RESULTS: Randomization was centralized, concealed, and stratified by surgeon with 153 patients in the WL group and 152 in RSL group. Localizations were performed using either ultrasound (70%) or mammographic guidance (30%). Pathology was either DCIS (18%) or invasive carcinoma (82%). Procedures were performed at 3 sites, by 7 surgeons. Only difference found for patient and tumor characteristics was more multifocal disease in RSL group. Using intention-to-treat analysis, there were no differences in positive margins rates for RSL (10.5%) and WL (11.8%), (P=.99) or for positive or close margins (<1 mm) (RSL 19% and WL 22%; P=.61). Mean operative time (minutes) was shorter for RSL (RSL 19.4 vs WL 22.2; P<.001). Specimen volume, weight, reoperation and localization times were similar. Surgeons ranked the seed technique as easier (P=.008), while radiologists ranked them similarly. Patient's pain rankings during wire localization were higher (P=.038). CONCLUSIONS: In contrast to other trials positive margin and reoperation rates were similar for RSL and WL. However, for RSL operative times were shorter, and the technique was preferred by surgeons, making it an acceptable method for localization. SN - 1534-4681 UR - https://www.unboundmedicine.com/medline/citation/21533657/A_multicentered_randomized_controlled_trial_comparing_radioguided_seed_localization_to_standard_wire_localization_for_nonpalpable_invasive_and_in_situ_breast_carcinomas_ L2 - https://dx.doi.org/10.1245/s10434-011-1699-y DB - PRIME DP - Unbound Medicine ER -