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Radioactive seed localization compared with wireguided localization of non-palpable breast carcinoma in breast conservation surgery-The first experience in the United Kingdom

Lookup NU author(s): Professor Tom Lennard, Joseph O'Donoghue, Stewart Nicholson, Henry Cain, Dr George Petrides

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Abstract

© 2018 The Authors. Objective: In the UK, guidewires have traditionally been used for localization of non-palpable breast lesions in patients undergoing breast conservation surgery (BCS). Radioactive seed localization (RSL) using Iodine-125 seeds is an alternative localization method and involves inserting a titanium capsule, containing radioactive Iodine-125, into the breast lesion. We aim to demonstrate feasibility of RSL compared with guidewire-localization (GWL) for BCS in the UK. Methods: Data were collected on 100 patients with non-palpable unifocal invasive carcinoma of the breast undergoing GWL WLE prior to the introduction of RSL and the first 100 patients treated with RSL WLE. Statistical comparisons were made using X2-squared analysis or unpaired two-sample t-Test. Significance was determined to be at p ≤0.05. Results: Mean total tumour size was 19.44 mm (range: 5-55) in the GWL group and 18.61 mm (range: 3.8-59) in the RSL group (p = 0.548), while mean total specimen excision weight was significantly lower in the RSL group; 31.55 g (range: 4.5-112) vs 37.42 g (range: 7.8-157.1) (p = 0.018). Although 15 patients had inadequate surgical resection margins in the GWL group compared the 13 in the RSL group (15 vs 13%, respectively, p = 0.684), 10 of the patients in the GWL group had invasive carcinoma present resulting in at least one positive margin compared with only 3 patients in the RSL group (10 vs 3%, respectively, p = 0.045). Conclusion: In this study, RSL is shown to be noninferior to the use of GWL for non-palpable carcinoma in patients undergoing BCS and we suggest that it could be introduced successfully in other breast units. Advances in knowledge: Here we have demonstrated the use of RSL localization results in significant lower weight resection specimens of breast carcinoma when compared with a matched group using GWL, without any significant differences in oncological outcome between the groups.


Publication metadata

Author(s): Milligan R, Pieri A, Critchley A, Peace R, Lennard T, O'Donoghue JM, Howitt RH, Nicholson S, Cain H, Petrides G, Sibal N

Publication type: Article

Publication status: Published

Journal: British Journal of Radiology

Year: 2018

Volume: 91

Issue: 1081

Print publication date: 01/01/2018

Online publication date: 16/11/2017

Acceptance date: 23/10/2017

ISSN (print): 0007-1285

ISSN (electronic): 1748-880X

Publisher: British Institute of Radiology

URL: https://doi.org/10.1259/bjr.20170268

DOI: 10.1259/bjr.20170268

PubMed id: 29076748


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