Randomized controlled clinical trial comparing radioguided occult lesion localization with wire-guided lesion localization to evaluate their efficacy and accuracy in the localization of nonpalpable breast lesions

Duarte, Carlos; Bastidas, Faustino; Reyes, Amelia de los; Martínez, María Cristina Quijano; Hurtado, Gloria Liliana Porras; Gómez, María Constanza; Pedraza, Ricardo Sánchez; Manrique, Jorge

doi:10.1016/j.surg.2015.09.023

Cited by 22 publications

(13 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite this bias, clip‐guided and ROLL‐guided excisions offered adequate resection volumes. Previously, the adequacy of resection volumes has been often evaluated on specimen volumes or weight, or patients’ cosmetic satisfaction . An accurate assessment of resected volumes is mandatory when a localization technique is evaluated, and current imprecisions and heterogeneity in volumes measurement have led to inconsistent results …”

Section: Discussionmentioning

confidence: 99%

“…Controversial results emerged from previous literature comparing different localization techniques . A recent meta‐analysis compared the effectiveness of ROLL versus radioactive seed (RSL) and wire‐guided localization (WGL): ROLL and RSL proved to be equivalent to WGL in terms of successful excision, although ROLL confirmed to be associated with improved cosmesis .…”

Section: Discussionmentioning

confidence: 99%

“…Previously, the adequacy of resection volumes has been often evaluated on specimen volumes or weight, or patients' cosmetic satisfaction. 8,[24][25][26][27][28][29][30] An accurate assessment of resected volumes is mandatory when a localization technique is evaluated, and current imprecisions and heterogeneity in volumes measurement have led to inconsistent results. 31,32 Certainly ROLL allowed an easier surgery and a higher confidence for surgeons, as demonstrated by the significantly lower operative time (52.7 vs 69.6 minutes), although the longer time required by TCC included the specimen X-ray with possible further excisions.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Radio‐guided and clip‐guided preoperative localization for malignant microcalcifications offer similar performances in breast‐conserving surgery

et al. 2019

View full text Add to dashboard Cite

Obtaining a tailored breast resection is challenging in microcalcifications detected on screening mammography, and an accurate localization is required. The aim of this study was to compare the efficacy of radio‐guided localization (ROLL) versus ultrasound localization of a titanium clip with collagen (TCC) in terms of clear margins, re‐intervention rates, excess of resected breast tissue, and operative times in pure malignant microcalcifications detected on screening mammography. Two hundred and twenty‐one consecutive patients with malignant microcalcifications detected on screening mammography from a tertiary breast unit were reviewed: 177 patients were localized by TCC and 44 patients by stereotactic ROLL. A propensity score‐matched analysis was performed, followed by a logistic regression model, to avoid selection bias. Adequacy of resection was expressed as the calculated resection ratio considering lesion size. No differences were found in clear margins with ROLL versus TCC (77.3% vs 81.8%, adjusted OR 2, P = 0.27). Re‐operation rates were similar, being 11.3% with ROLL and 7.4% with TCC (P = 0.627). Mean resection volume was 46.2 cm3 with ROLL versus 54.2 cm3 with TCC (P = 0.222). Adjusted mean calculated resection ratio was 1.8 with ROLL and 2.1 with TCC (P = 0.38). Surgery time was longer with TCC compared to ROLL (69.6 vs 52.7 minutes, P < 0.0001). ROLL and TCC are equally effective to excise malignant microcalcifications with clear margins, providing similar re‐intervention rates and resection volumes.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Radio‐guided and clip‐guided preoperative localization for malignant microcalcifications offer similar performances in breast‐conserving surgery

et al. 2019

View full text Add to dashboard Cite

show abstract

“…This finding is not markedly different from the positive margin rate reported in other studies where BCS was performed after localization using ultrasonography or wire localization. [ 8 – 10 ] The localization methods used during BCS for nonpalpable breast cancer include PWL, ROLL, RSL, and intraoperative ultrasonography. [ 5 ] The negative margin rate with PWL, the gold standard method, varies widely from 55% to 91%.…”

Section: Discussionmentioning

confidence: 99%

Comparison of outcomes of surgeon-performed intraoperative ultrasonography-guided wire localization and preoperative wire localization in nonpalpable breast cancer patients undergoing breast-conserving surgery

Shin¹,

Choi

Kim

et al. 2017

Medicine

View full text Add to dashboard Cite

This study aimed to determine the efficacy of intraoperative ultrasonography-guided wire localization guided breast-conserving surgery (BCS) for nonpalpable breast cancer and compare it to conventional preoperative wire localization (PWL) guided surgery.We retrospectively analyzed the medical charts of 214 consecutive nonpalpable breast cancer patients who underwent BCS using intraoperative ultrasonography-guided wire localization by a surgeon (IUWLS) and PWL, between April 2013 and March 2017. Positive surgical margins, reexcision rates, and resection volumes were investigated.Of the total cohort, 124 patients underwent BCS with IUWLS and 90 patients with PWL. The following did not differ between the IUWLS and PWL groups: positive margin status, re-excision rate, conversion rate, permanent positive margin status, reoperation rate, median optimal resection volume (ORV), median total resection volume (TRV), and median closest tumor-free margin. Rather, median (range) widest tumor-free margin was significantly smaller in the IUWLS group (9 mm [5–12]) than in the PWL group (14 mm [9–20]; P = .003]). Median (range) calculated resection ratio (CRR) was significantly lower in the IUWLS group (1.67 [0.87–9.38]) than in the PWL group (4.83 [1.63–21.04]; P = .02).In nonpalpable breast cancer patients undergoing BCS, IUWLS showed positive resection margins and reexcision rates equivalent to those of the conventional PWL method. Additionally, excision volume and widest tumor-free margin were smaller with IUWLS, confirming that healthy breast tissue is less likely to be resected with this method. Our results suggest that IUWLS offers an excellent alternative to PWL, while avoiding PWL-induced patient discomfort.

show abstract

“…26 No differences were observed in surgery time between ROLL and TCC (respectively, 65 vs 62.9 minutes) despite operative time 34,35 Most of the previous studies were designed before the recent definition of adequate margins for invasive cancer and DCIS, and frequently patients with benign or uncertain lesions were included, conversely to the present study. 8,[27][28][29][30][31][32][33] Furthermore, adequacy of resection has been often evaluated on specimen volumes or weight, kind of studies since adequacy of resection is the main end-point for breast-conserving surgery of nonpalpable cancers, and current imprecisions and heterogeneity in volumes measurement have led to inconsistent or controversial results. 36,37 A limitation of the present study is its retrospective and nonrandom design, which could have potentially affected the distribution of baseline variables between groups.…”

Section: Mass-like Lesions Such As Nodules or Distortions Have Been Omentioning

confidence: 99%

Radio‐guided vs clip‐guided localization of nonpalpable mass‐like lesions of the breast from a screened population: A propensity score‐matched study

Corsi

Bossi

Combi

et al. 2019

Journal of Surgical Oncology

View full text Add to dashboard Cite

Background and Objectives An accurate localization is mandatory to tailor breast lumpectomy in nonpalpable cancers. The aim of this study was to compare radio‐guided localization (ROLL) vs ultrasound localization of a titanium clip with collagen (TCC) in nonpalpable mass‐like breast cancers. Methods Two hundred seventy‐three consecutive patients were reviewed: 64 patients were localized by TCC and 209 patients by ROLL. Propensity score‐matched analysis was performed. Margin status and reintervention rates were compared. Adequacy of resection was expressed as the calculated resection ratio (CRR) considering lesion size. Loco‐regional and distant recurrence rates were assessed with ROLL vs TCC. Results No differences were found with ROLL vs TCC in clear margins (90.6% vs 89.1%; odds ratio, 0.74; P = 0.64) or reoperations (6.7% vs 1.6%; P = 0.529). ROLL allowed more tailored resections compared with TCC (adjusted CRR, 1.7 vs 2.7; P = 0.0008), particularly in lesions with associated extensive intraductal component (CRR, 3.0 vs 4.5; P = 0.017). Loco‐regional recurrence occurred in 1.9% of ROLL patients vs 3.2% of TCC cases (P = 0.628). Conclusions ROLL and TCC are equally effective to excise nonpalpable mass‐like breast cancers with clear margins, providing similar loco‐regional control. However, ROLL allows more tailored breast resections, particularly in lesions with the associated extensive intraductal component.

show abstract

Randomized controlled clinical trial comparing radioguided occult lesion localization with wire-guided lesion localization to evaluate their efficacy and accuracy in the localization of nonpalpable breast lesions

Cited by 22 publications

References 25 publications

Radio‐guided and clip‐guided preoperative localization for malignant microcalcifications offer similar performances in breast‐conserving surgery

Radio‐guided and clip‐guided preoperative localization for malignant microcalcifications offer similar performances in breast‐conserving surgery

Comparison of outcomes of surgeon-performed intraoperative ultrasonography-guided wire localization and preoperative wire localization in nonpalpable breast cancer patients undergoing breast-conserving surgery

Radio‐guided vs clip‐guided localization of nonpalpable mass‐like lesions of the breast from a screened population: A propensity score‐matched study

Contact Info

Product

Resources

About