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Guiding breast-conserving surgery in patients after neoadjuvant systemic therapy for breast cancer: a comparison of radioactive seed localization with the ROLL technique.
Ann Surg Oncol 2013; 20(8):2569-75AS

Abstract

BACKGROUND

Radioguided occult lesion localization (ROLL) with technetium-99 m colloid (ROLL-(99m)Tc) is commonly used to perform breast-conserving surgery in patients with nonpalpable breast tumors. Radioactive seed localization is a relatively new technique that localizes the tumor with a radioactive iodine-125 ((125)I) seed. The feasibility and outcome of these techniques after neoadjuvant systemic treatment has not been widely investigated.

METHODS

All patients treated with neoadjuvant systemic treatment between 2007 and 2010 in the Netherlands Cancer Institute who underwent breast-conserving surgery with the ROLL-(99m)Tc technique (n = 83) or with (125)I seed localization (n = 71) were analyzed. The weight of the resected specimen, the margins, and the percentage of patients requiring a second surgical intervention as a result of positive margins were assessed.

RESULTS

Patient and tumor characteristics and systemic treatment regimens were comparable between both groups. The median weight of the resected specimen (53 vs. 48 g), the median smallest margin (3.5 vs. 3.0 mm), and the risk for additional surgery for incomplete resections (7 vs. 8 %) did not differ significantly between patients treated with the ROLL-(99m)Tc technique and (125)I seed localization.

CONCLUSIONS

The ROLL-(99m)Tc technique and (125)I seed localization demonstrate comparable results when used to perform breast-conserving surgery after neoadjuvant systemic treatment. Because (125)I seed localization does not require additional radiological localization shortly before surgery, it simplifies surgery scheduling. Therefore, we prefer (125)I seed localization to perform breast-conserving surgery after neoadjuvant systemic treatment.

Authors+Show Affiliations

Department of Surgical Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.No affiliation info availableNo 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

Language

eng

PubMed ID

23463088

Citation

Donker, Mila, et al. "Guiding Breast-conserving Surgery in Patients After Neoadjuvant Systemic Therapy for Breast Cancer: a Comparison of Radioactive Seed Localization With the ROLL Technique." Annals of Surgical Oncology, vol. 20, no. 8, 2013, pp. 2569-75.
Donker M, Drukker CA, Valdés Olmos RA, et al. Guiding breast-conserving surgery in patients after neoadjuvant systemic therapy for breast cancer: a comparison of radioactive seed localization with the ROLL technique. Ann Surg Oncol. 2013;20(8):2569-75.
Donker, M., Drukker, C. A., Valdés Olmos, R. A., Rutgers, E. J., Loo, C. E., Sonke, G. S., ... Vrancken Peeters, M. J. (2013). Guiding breast-conserving surgery in patients after neoadjuvant systemic therapy for breast cancer: a comparison of radioactive seed localization with the ROLL technique. Annals of Surgical Oncology, 20(8), pp. 2569-75. doi:10.1245/s10434-013-2921-x.
Donker M, et al. Guiding Breast-conserving Surgery in Patients After Neoadjuvant Systemic Therapy for Breast Cancer: a Comparison of Radioactive Seed Localization With the ROLL Technique. Ann Surg Oncol. 2013;20(8):2569-75. PubMed PMID: 23463088.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Guiding breast-conserving surgery in patients after neoadjuvant systemic therapy for breast cancer: a comparison of radioactive seed localization with the ROLL technique. AU - Donker,Mila, AU - Drukker,Caroline A, AU - Valdés Olmos,Renato A, AU - Rutgers,Emiel J Th, AU - Loo,Claudette E, AU - Sonke,Gabe S, AU - Wesseling,Jelle, AU - Alderliesten,Tanja, AU - Vrancken Peeters,Marie-Jeanne T F D, Y1 - 2013/03/06/ PY - 2012/06/29/received PY - 2013/3/7/entrez PY - 2013/3/7/pubmed PY - 2013/12/18/medline SP - 2569 EP - 75 JF - Annals of surgical oncology JO - Ann. Surg. Oncol. VL - 20 IS - 8 N2 - BACKGROUND: Radioguided occult lesion localization (ROLL) with technetium-99 m colloid (ROLL-(99m)Tc) is commonly used to perform breast-conserving surgery in patients with nonpalpable breast tumors. Radioactive seed localization is a relatively new technique that localizes the tumor with a radioactive iodine-125 ((125)I) seed. The feasibility and outcome of these techniques after neoadjuvant systemic treatment has not been widely investigated. METHODS: All patients treated with neoadjuvant systemic treatment between 2007 and 2010 in the Netherlands Cancer Institute who underwent breast-conserving surgery with the ROLL-(99m)Tc technique (n = 83) or with (125)I seed localization (n = 71) were analyzed. The weight of the resected specimen, the margins, and the percentage of patients requiring a second surgical intervention as a result of positive margins were assessed. RESULTS: Patient and tumor characteristics and systemic treatment regimens were comparable between both groups. The median weight of the resected specimen (53 vs. 48 g), the median smallest margin (3.5 vs. 3.0 mm), and the risk for additional surgery for incomplete resections (7 vs. 8 %) did not differ significantly between patients treated with the ROLL-(99m)Tc technique and (125)I seed localization. CONCLUSIONS: The ROLL-(99m)Tc technique and (125)I seed localization demonstrate comparable results when used to perform breast-conserving surgery after neoadjuvant systemic treatment. Because (125)I seed localization does not require additional radiological localization shortly before surgery, it simplifies surgery scheduling. Therefore, we prefer (125)I seed localization to perform breast-conserving surgery after neoadjuvant systemic treatment. SN - 1534-4681 UR - https://www.unboundmedicine.com/medline/citation/23463088/Guiding_breast_conserving_surgery_in_patients_after_neoadjuvant_systemic_therapy_for_breast_cancer:_a_comparison_of_radioactive_seed_localization_with_the_ROLL_technique_ L2 - https://dx.doi.org/10.1245/s10434-013-2921-x DB - PRIME DP - Unbound Medicine ER -