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Radioactive seed localization compared to wire localization in breast-conserving surgery: initial 6-month experience.
Ann Surg Oncol 2013; 20(13):4121-7AS

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 (125)iodine 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.

Authors+Show Affiliations

Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.No 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)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

23943024

Citation

Murphy, James O., et al. "Radioactive Seed Localization Compared to Wire Localization in Breast-conserving Surgery: Initial 6-month Experience." Annals of Surgical Oncology, vol. 20, no. 13, 2013, pp. 4121-7.
Murphy JO, Moo TA, King TA, et al. Radioactive seed localization compared to wire localization in breast-conserving surgery: initial 6-month experience. Ann Surg Oncol. 2013;20(13):4121-7.
Murphy, J. O., Moo, T. A., King, T. A., Van Zee, K. J., Villegas, K. A., Stempel, M., ... Morrow, M. (2013). Radioactive seed localization compared to wire localization in breast-conserving surgery: initial 6-month experience. Annals of Surgical Oncology, 20(13), pp. 4121-7. doi:10.1245/s10434-013-3166-4.
Murphy JO, et al. Radioactive Seed Localization Compared to Wire Localization in Breast-conserving Surgery: Initial 6-month Experience. Ann Surg Oncol. 2013;20(13):4121-7. PubMed PMID: 23943024.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Radioactive seed localization compared to wire localization in breast-conserving surgery: initial 6-month experience. AU - Murphy,James O, AU - Moo,Tracy-Ann, AU - King,Tari A, AU - Van Zee,Kimberly J, AU - Villegas,Kristine A, AU - Stempel,Michelle, AU - Eaton,Anne, AU - St Germain,Jean M, AU - Morris,Elizabeth, AU - Morrow,Monica, Y1 - 2013/08/14/ PY - 2013/04/29/received PY - 2013/8/15/entrez PY - 2013/8/15/pubmed PY - 2014/6/28/medline SP - 4121 EP - 7 JF - Annals of surgical oncology JO - Ann. Surg. Oncol. VL - 20 IS - 13 N2 - 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 (125)iodine 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. SN - 1534-4681 UR - https://www.unboundmedicine.com/medline/citation/23943024/Radioactive_seed_localization_compared_to_wire_localization_in_breast_conserving_surgery:_initial_6_month_experience_ L2 - https://dx.doi.org/10.1245/s10434-013-3166-4 DB - PRIME DP - Unbound Medicine ER -