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Breast conserving surgery for extensive DCIS using multiple radioactive seeds.
Eur J Surg Oncol 2018; 44(1):67-73EJ

Abstract

BACKGROUND AND OBJECTIVES

Breast conserving surgery (BCS) can be challenging for large regions of ductal carcinoma in situ (DCIS), resulting in high rates of positive resection margins. Radioactive seed localization (RSL) using multiple radioactive iodine (125I) seeds can be used to bracket extensive DCIS (eDCIS). The goal of this study was to retrospectively compare the use of a single or multiple 125I seeds in RSL to enable BCS in patients with eDCIS.

METHODS

All patients with eDCIS (area of ≥3.0 cm) who underwent either single or multiple-seed RSL between January 2008 and December 2016 were included. Patient, tumor and surgery characteristics were compared between both groups. Primary outcome measures were positive resection margin and re-operation rates.

RESULTS

Respectively 48 and 58 patients with eDCIS underwent single- and multiple-seed RSL and subsequent BCS. The rate of positive resection margin (focal and more than focal) with single-seed RSL was 47.9%, compared to 29.3% with multiple-seed RSL (p = 0.06). The re-operation rate was 39.6% with single-seed RSL and 20.7% in the multiple-seed RSL group (p = 0.05).

CONCLUSION

Multiple-seed RSL enables bracketing of large areas of DCIS, with the potential to decrease the high rate of positive resection margins in this patient group.

Authors+Show Affiliations

Department of Radiation Oncology, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.Department of Surgical Oncology, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.Department of Radiology, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.Department of Pathology, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.Department of Plastic and Reconstructive Surgery, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.Department of Surgical Oncology, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.Department of Surgical Oncology, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.Department of Surgical Oncology, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. Electronic address: m.vrancken@nki.nl.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29239733

Citation

Janssen, N N Y., et al. "Breast Conserving Surgery for Extensive DCIS Using Multiple Radioactive Seeds." European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, vol. 44, no. 1, 2018, pp. 67-73.
Janssen NNY, van la Parra RFD, Loo CE, et al. Breast conserving surgery for extensive DCIS using multiple radioactive seeds. Eur J Surg Oncol. 2018;44(1):67-73.
Janssen, N. N. Y., van la Parra, R. F. D., Loo, C. E., Groen, E. J., van den Berg, M. J., Oldenburg, H. S. A., ... Vrancken Peeters, M. T. F. D. (2018). Breast conserving surgery for extensive DCIS using multiple radioactive seeds. European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 44(1), pp. 67-73. doi:10.1016/j.ejso.2017.11.002.
Janssen NNY, et al. Breast Conserving Surgery for Extensive DCIS Using Multiple Radioactive Seeds. Eur J Surg Oncol. 2018;44(1):67-73. PubMed PMID: 29239733.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Breast conserving surgery for extensive DCIS using multiple radioactive seeds. AU - Janssen,N N Y, AU - van la Parra,R F D, AU - Loo,C E, AU - Groen,E J, AU - van den Berg,M J, AU - Oldenburg,H S A, AU - Nijkamp,J, AU - Vrancken Peeters,M T F D, Y1 - 2017/11/20/ PY - 2017/08/03/received PY - 2017/09/26/revised PY - 2017/11/06/accepted PY - 2017/12/15/pubmed PY - 2018/4/25/medline PY - 2017/12/15/entrez KW - Breast conserving surgery KW - Extensive DCIS KW - Non-palpable breast cancer KW - Radioactive seed localization SP - 67 EP - 73 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 - 44 IS - 1 N2 - BACKGROUND AND OBJECTIVES: Breast conserving surgery (BCS) can be challenging for large regions of ductal carcinoma in situ (DCIS), resulting in high rates of positive resection margins. Radioactive seed localization (RSL) using multiple radioactive iodine (125I) seeds can be used to bracket extensive DCIS (eDCIS). The goal of this study was to retrospectively compare the use of a single or multiple 125I seeds in RSL to enable BCS in patients with eDCIS. METHODS: All patients with eDCIS (area of ≥3.0 cm) who underwent either single or multiple-seed RSL between January 2008 and December 2016 were included. Patient, tumor and surgery characteristics were compared between both groups. Primary outcome measures were positive resection margin and re-operation rates. RESULTS: Respectively 48 and 58 patients with eDCIS underwent single- and multiple-seed RSL and subsequent BCS. The rate of positive resection margin (focal and more than focal) with single-seed RSL was 47.9%, compared to 29.3% with multiple-seed RSL (p = 0.06). The re-operation rate was 39.6% with single-seed RSL and 20.7% in the multiple-seed RSL group (p = 0.05). CONCLUSION: Multiple-seed RSL enables bracketing of large areas of DCIS, with the potential to decrease the high rate of positive resection margins in this patient group. SN - 1532-2157 UR - https://www.unboundmedicine.com/medline/citation/29239733/Breast_conserving_surgery_for_extensive_DCIS_using_multiple_radioactive_seeds_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0748-7983(17)30960-5 DB - PRIME DP - Unbound Medicine ER -