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The use of radioactive iodine-125 seed localization in patients with non-palpable breast cancer: a comparison with the radioguided occult lesion localization with 99m technetium.
Eur J Surg Oncol 2015; 41(4):553-8EJ

Abstract

BACKGROUND

Radioactive Seed Localization with a radioactive iodine-125 seed (RSL) and Radioguided Occult Lesion Localization with 99mTechnetium colloid (ROLL) are both attractive alternatives to wire localization for guiding breast conserving surgery (BCS) of non-palpable breast cancer. The aim of this study was to evaluate and compare the efficacy of RSL and ROLL.

METHODS

We retrospectively analyzed 387 patients with unifocal non-palpable ductal carcinoma in situ (DCIS) or invasive carcinoma treated with BCS at the Netherlands Cancer Institute. In total 403 non-palpable lesions were localized either by RSL (N = 128) or by ROLL (N = 275). Primary outcome measures were positive margins and re-excision rates; the secondary outcome measure was weight of the specimen.

RESULTS

Pre-operative mammography or ultrasound showed similar sizes of DCIS and invasive tumours in both RSL and ROLL groups. In the RSL group, more lesions were DCIS (58%) than in the ROLL group, where 32% of the lesions were pure DCIS. The proportions of focally positive margins (11% vs. 10%) and more than focally positive margins (9% vs. 9%) were comparable between the RSL and the ROLL group, resulting in the same re-excision rate in both RSL and ROLL groups (9% vs. 10%). For DCIS lesions, the specimen weight was significantly lower in the RSL group than in the ROLL group after adjusting for tumour size on mammography (12 g; 95% CI 2.6-21).

CONCLUSION

Margin status and re-excision rates were comparable for RSL and ROLL in patients with non-palpable breast lesions. Because of the significant lower weight of the resected specimen in DCIS, the feasibility of position verification of the I-125 seed and more convenient logistics, we favour RSL over ROLL to guide breast-conserving therapy.

Authors+Show Affiliations

Department of Surgery, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.Department of Radiology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.Department of Pathology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.Department of Medical Statistics, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.Department of Surgery, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.Department of Radiology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.Department of Nuclear Medicine, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.Department of Surgery, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. Electronic address: m.vrancken@nki.nl.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

25707349

Citation

van der Noordaa, M E M., et al. "The Use of Radioactive Iodine-125 Seed Localization in Patients With Non-palpable Breast Cancer: a Comparison With the Radioguided Occult Lesion Localization With 99m Technetium." European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, vol. 41, no. 4, 2015, pp. 553-8.
van der Noordaa ME, Pengel KE, Groen E, et al. The use of radioactive iodine-125 seed localization in patients with non-palpable breast cancer: a comparison with the radioguided occult lesion localization with 99m technetium. Eur J Surg Oncol. 2015;41(4):553-8.
van der Noordaa, M. E., Pengel, K. E., Groen, E., van Werkhoven, E., Rutgers, E. J., Loo, C. E., ... Vrancken Peeters, M. J. (2015). The use of radioactive iodine-125 seed localization in patients with non-palpable breast cancer: a comparison with the radioguided occult lesion localization with 99m technetium. European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 41(4), pp. 553-8. doi:10.1016/j.ejso.2015.01.022.
van der Noordaa ME, et al. The Use of Radioactive Iodine-125 Seed Localization in Patients With Non-palpable Breast Cancer: a Comparison With the Radioguided Occult Lesion Localization With 99m Technetium. Eur J Surg Oncol. 2015;41(4):553-8. PubMed PMID: 25707349.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The use of radioactive iodine-125 seed localization in patients with non-palpable breast cancer: a comparison with the radioguided occult lesion localization with 99m technetium. AU - van der Noordaa,M E M, AU - Pengel,K E, AU - Groen,E, AU - van Werkhoven,E, AU - Rutgers,E J Th, AU - Loo,C E, AU - Vogel,W, AU - Vrancken Peeters,M J T F D, Y1 - 2015/02/03/ PY - 2014/11/04/received PY - 2015/01/11/revised PY - 2015/01/15/accepted PY - 2015/2/25/entrez PY - 2015/2/25/pubmed PY - 2015/5/27/medline KW - Breast conserving surgery KW - Non-palpable breast cancer KW - Non-palpable breast lesions KW - Radioactive seed localization KW - Radioguided occult lesion localization SP - 553 EP - 8 JF - European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology JO - Eur J Surg Oncol VL - 41 IS - 4 N2 - BACKGROUND: Radioactive Seed Localization with a radioactive iodine-125 seed (RSL) and Radioguided Occult Lesion Localization with 99mTechnetium colloid (ROLL) are both attractive alternatives to wire localization for guiding breast conserving surgery (BCS) of non-palpable breast cancer. The aim of this study was to evaluate and compare the efficacy of RSL and ROLL. METHODS: We retrospectively analyzed 387 patients with unifocal non-palpable ductal carcinoma in situ (DCIS) or invasive carcinoma treated with BCS at the Netherlands Cancer Institute. In total 403 non-palpable lesions were localized either by RSL (N = 128) or by ROLL (N = 275). Primary outcome measures were positive margins and re-excision rates; the secondary outcome measure was weight of the specimen. RESULTS: Pre-operative mammography or ultrasound showed similar sizes of DCIS and invasive tumours in both RSL and ROLL groups. In the RSL group, more lesions were DCIS (58%) than in the ROLL group, where 32% of the lesions were pure DCIS. The proportions of focally positive margins (11% vs. 10%) and more than focally positive margins (9% vs. 9%) were comparable between the RSL and the ROLL group, resulting in the same re-excision rate in both RSL and ROLL groups (9% vs. 10%). For DCIS lesions, the specimen weight was significantly lower in the RSL group than in the ROLL group after adjusting for tumour size on mammography (12 g; 95% CI 2.6-21). CONCLUSION: Margin status and re-excision rates were comparable for RSL and ROLL in patients with non-palpable breast lesions. Because of the significant lower weight of the resected specimen in DCIS, the feasibility of position verification of the I-125 seed and more convenient logistics, we favour RSL over ROLL to guide breast-conserving therapy. SN - 1532-2157 UR - https://www.unboundmedicine.com/medline/citation/25707349/The_use_of_radioactive_iodine_125_seed_localization_in_patients_with_non_palpable_breast_cancer:_a_comparison_with_the_radioguided_occult_lesion_localization_with_99m_technetium_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0748-7983(15)00055-4 DB - PRIME DP - Unbound Medicine ER -