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
| Autor: | M E M, van der Noordaa, K E, Pengel, E, Groen, E, van Werkhoven, E J Th, Rutgers, C E, Loo, W, Vogel, M J T F D, Vrancken Peeters |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Reoperation Neoplasm Residual Carcinoma Ductal Breast Breast Neoplasms Middle Aged Mastectomy Segmental Tumor Burden Iodine Radioisotopes Carcinoma Intraductal Noninfiltrating Humans Female Ultrasonography Mammary Radiopharmaceuticals Radionuclide Imaging Technetium Tc 99m Aggregated Albumin Aged Mammography Retrospective Studies |
| Zdroj: | European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 41(4) |
| ISSN: | 1532-2157 |
| Popis: | 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.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.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).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. |
| Databáze: | OpenAIRE |
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