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Safety and efficacy of radioactive seed localization with I-125 prior to lumpectomy and/or excisional biopsy.
Eur J Radiol 2013; 82(9):1453-7EJ

Abstract

PURPOSE

To evaluate the safety and efficacy of pre-operative I-125 radioactive seed localization (RSL) as an alternative to wire localization (WL).

METHODS

A waiver was granted by the institutional review board for this HIPAA compliant study. Review of 356 consecutive single site nonpalpable mammographic and ultrasound guided I-125 RSLs done between November 2011 and April 2012 was conducted. Preoperative mammograms and specimen radiographs were reviewed for seed-target distance, lesion location, and target/seed removal. During a brief surgical training period, 35 of 356 women had both RSL and wire localization (WL) of the same lesion. Chi-square and single sample t-tests were used to compare margin status and duration of procedures.

RESULTS

Of the 356 RSLs, 303 (85.1%) were performed ≥ 1 day before surgery. Mammographic guidance was used in 330 (93%) and ultrasound in 26 (7%). Mean seed to target distance was 1mm (range 0-20mm); all targeted lesions were retrieved. In 31 women in whom mammographic guidance was used for both RSL and WL, median procedure time was not significantly different (RSL 9.0 min; WL 7.0 min; p=0.91), and median seed migration distance was <1mm (range 0-15 mm). No difference was detected between margin status with RSL alone versus WL (p=0.40 and p=0.65 for positive and <1mm margins, respectively). Two adverse events occurred requiring an additional wire/surgery.

CONCLUSION

RSL ≥ 1 day before surgery is a safe effective procedure for pre-operative localization, with few adverse events and surgical outcomes comparable to those achieved with wire localization.

Authors+Show Affiliations

Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY, United States. sungj@mskcc.orgNo affiliation info availableNo 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)

Clinical Trial
Journal Article

Language

eng

PubMed ID

23684386

Citation

Sung, Janice S., et al. "Safety and Efficacy of Radioactive Seed Localization With I-125 Prior to Lumpectomy And/or Excisional Biopsy." European Journal of Radiology, vol. 82, no. 9, 2013, pp. 1453-7.
Sung JS, King V, Thornton CM, et al. Safety and efficacy of radioactive seed localization with I-125 prior to lumpectomy and/or excisional biopsy. Eur J Radiol. 2013;82(9):1453-7.
Sung, J. S., King, V., Thornton, C. M., Brooks, J. D., Fry, C. W., El-Tamer, M., ... Morris, E. A. (2013). Safety and efficacy of radioactive seed localization with I-125 prior to lumpectomy and/or excisional biopsy. European Journal of Radiology, 82(9), pp. 1453-7. doi:10.1016/j.ejrad.2013.04.008.
Sung JS, et al. Safety and Efficacy of Radioactive Seed Localization With I-125 Prior to Lumpectomy And/or Excisional Biopsy. Eur J Radiol. 2013;82(9):1453-7. PubMed PMID: 23684386.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Safety and efficacy of radioactive seed localization with I-125 prior to lumpectomy and/or excisional biopsy. AU - Sung,Janice S, AU - King,Valencia, AU - Thornton,Cynthia M, AU - Brooks,Jennifer D, AU - Fry,Charles W, AU - El-Tamer,Mahmoud, AU - Dauer,Lawrence T, AU - Brogi,Edi, AU - St Germain,Jean M, AU - Morris,Elizabeth A, Y1 - 2013/05/14/ PY - 2013/02/18/received PY - 2013/04/18/accepted PY - 2013/5/21/entrez PY - 2013/5/21/pubmed PY - 2014/3/4/medline KW - Breast intervention KW - Mammography SP - 1453 EP - 7 JF - European journal of radiology JO - Eur J Radiol VL - 82 IS - 9 N2 - PURPOSE: To evaluate the safety and efficacy of pre-operative I-125 radioactive seed localization (RSL) as an alternative to wire localization (WL). METHODS: A waiver was granted by the institutional review board for this HIPAA compliant study. Review of 356 consecutive single site nonpalpable mammographic and ultrasound guided I-125 RSLs done between November 2011 and April 2012 was conducted. Preoperative mammograms and specimen radiographs were reviewed for seed-target distance, lesion location, and target/seed removal. During a brief surgical training period, 35 of 356 women had both RSL and wire localization (WL) of the same lesion. Chi-square and single sample t-tests were used to compare margin status and duration of procedures. RESULTS: Of the 356 RSLs, 303 (85.1%) were performed ≥ 1 day before surgery. Mammographic guidance was used in 330 (93%) and ultrasound in 26 (7%). Mean seed to target distance was 1mm (range 0-20mm); all targeted lesions were retrieved. In 31 women in whom mammographic guidance was used for both RSL and WL, median procedure time was not significantly different (RSL 9.0 min; WL 7.0 min; p=0.91), and median seed migration distance was <1mm (range 0-15 mm). No difference was detected between margin status with RSL alone versus WL (p=0.40 and p=0.65 for positive and <1mm margins, respectively). Two adverse events occurred requiring an additional wire/surgery. CONCLUSION: RSL ≥ 1 day before surgery is a safe effective procedure for pre-operative localization, with few adverse events and surgical outcomes comparable to those achieved with wire localization. SN - 1872-7727 UR - https://www.unboundmedicine.com/medline/citation/23684386/Safety_and_efficacy_of_radioactive_seed_localization_with_I_125_prior_to_lumpectomy_and/or_excisional_biopsy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0720-048X(13)00203-9 DB - PRIME DP - Unbound Medicine ER -