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The introduction of radioactive seed localisation improves the oncological outcome of image guided breast conservation surgery.
Breast 2017; 36:49-53B

Abstract

INTRODUCTION

Radioactive seed localisation (RSL) has become increasingly popular for localisation of non-palpable breast tumours. This is largely due to advantages it offers in terms of practicality and convenience when compared to guide wire localisation (WL). This institute switched from using WL to RSL in September 2014. The primary aim was to assess whether this change improved the accuracy of excision with regards to inadequate margin rates and weight of excision specimens. The secondary aim was to establish whether there is a "learning curve" associated with RSL technique.

METHODS

Retrospective data collection was performed for 333 consecutive cases of unifocal non-palpable invasive breast cancers undergoing excision with WL or RSL. An inadequate margin was defined as tumour <1 mm from an inked radial margin. Patient demographics, tumour characteristics and clinical outcomes were compared between WL and RSL cases.

RESULTS

100 WL and 233 RSL cases were included. Patient demographics and tumour characteristics were similar for both groups. Inadequate margin rates were 18% with WL and 8.6% with RSL (p = 0.013). Median specimen weights were 33.3 g with WL and 28.7 g with RSL (p = 0.014). Subdividing the RSL group into the first 100 cases performed (RSL1) and the subsequent 133 cases (RSL2), inadequate margin rates were 13.0% and 5.3% respectively (p = 0.037). Mean specimen weights were similar.

CONCLUSION

Switching from WL to RSL results in a significant reduction in both inadequate margin rates and specimen weights. A procedure-specific learning curve is present on first implementation of RSL and following this, inadequate margin rates are further reduced.

Authors+Show Affiliations

Department of Breast Surgery, Royal Victoria Infirmary, Newcastle Upon Tyne, UK. Electronic address: apieri@doctors.net.uk.Department of Breast Surgery, Royal Victoria Infirmary, Newcastle Upon Tyne, UK.Department of Breast Surgery, Royal Victoria Infirmary, Newcastle Upon Tyne, UK.Department of Breast Surgery, Royal Victoria Infirmary, Newcastle Upon Tyne, UK.Department of Radiology, Royal Victoria Infirmary, Newcastle Upon Tyne, UK.Department of Radiology, Royal Victoria Infirmary, Newcastle Upon Tyne, UK.Department of Radiology, Royal Victoria Infirmary, Newcastle Upon Tyne, UK.Department of Cellular Pathology, Royal Victoria Infirmary, Newcastle Upon Tyne, UK.Department of Breast Surgery, Royal Victoria Infirmary, Newcastle Upon Tyne, UK.Department of Breast Surgery, Royal Victoria Infirmary, Newcastle Upon Tyne, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28945991

Citation

Pieri, A, et al. "The Introduction of Radioactive Seed Localisation Improves the Oncological Outcome of Image Guided Breast Conservation Surgery." Breast (Edinburgh, Scotland), vol. 36, 2017, pp. 49-53.
Pieri A, Milligan R, Critchley A, et al. The introduction of radioactive seed localisation improves the oncological outcome of image guided breast conservation surgery. Breast. 2017;36:49-53.
Pieri, A., Milligan, R., Critchley, A., O'Donoghue, J. M., Sibal, N., Peace, R., ... Cain, H. (2017). The introduction of radioactive seed localisation improves the oncological outcome of image guided breast conservation surgery. Breast (Edinburgh, Scotland), 36, pp. 49-53. doi:10.1016/j.breast.2017.09.004.
Pieri A, et al. The Introduction of Radioactive Seed Localisation Improves the Oncological Outcome of Image Guided Breast Conservation Surgery. Breast. 2017;36:49-53. PubMed PMID: 28945991.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The introduction of radioactive seed localisation improves the oncological outcome of image guided breast conservation surgery. AU - Pieri,A, AU - Milligan,R, AU - Critchley,A, AU - O'Donoghue,J M, AU - Sibal,N, AU - Peace,R, AU - Petrides,G, AU - Howitt,R, AU - Nicholson,S, AU - Cain,H, Y1 - 2017/09/22/ PY - 2017/05/12/received PY - 2017/07/01/revised PY - 2017/09/16/accepted PY - 2017/9/26/pubmed PY - 2018/6/21/medline PY - 2017/9/26/entrez KW - Breast KW - I-125 KW - Iodine-125 KW - Localisation KW - Radioactive KW - Seed KW - Wire SP - 49 EP - 53 JF - Breast (Edinburgh, Scotland) JO - Breast VL - 36 N2 - INTRODUCTION: Radioactive seed localisation (RSL) has become increasingly popular for localisation of non-palpable breast tumours. This is largely due to advantages it offers in terms of practicality and convenience when compared to guide wire localisation (WL). This institute switched from using WL to RSL in September 2014. The primary aim was to assess whether this change improved the accuracy of excision with regards to inadequate margin rates and weight of excision specimens. The secondary aim was to establish whether there is a "learning curve" associated with RSL technique. METHODS: Retrospective data collection was performed for 333 consecutive cases of unifocal non-palpable invasive breast cancers undergoing excision with WL or RSL. An inadequate margin was defined as tumour <1 mm from an inked radial margin. Patient demographics, tumour characteristics and clinical outcomes were compared between WL and RSL cases. RESULTS: 100 WL and 233 RSL cases were included. Patient demographics and tumour characteristics were similar for both groups. Inadequate margin rates were 18% with WL and 8.6% with RSL (p = 0.013). Median specimen weights were 33.3 g with WL and 28.7 g with RSL (p = 0.014). Subdividing the RSL group into the first 100 cases performed (RSL1) and the subsequent 133 cases (RSL2), inadequate margin rates were 13.0% and 5.3% respectively (p = 0.037). Mean specimen weights were similar. CONCLUSION: Switching from WL to RSL results in a significant reduction in both inadequate margin rates and specimen weights. A procedure-specific learning curve is present on first implementation of RSL and following this, inadequate margin rates are further reduced. SN - 1532-3080 UR - https://www.unboundmedicine.com/medline/citation/28945991/The_introduction_of_radioactive_seed_localisation_improves_the_oncological_outcome_of_image_guided_breast_conservation_surgery_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0960-9776(17)30576-3 DB - PRIME DP - Unbound Medicine ER -