Localisation accuracy with iodine‐125 seed versus wire guidance for breast cancer surgery

Autor: Shoba Ratnagobal, Donna Taylor, Anita G. Bourke, Meredith Kessell, Carolyn Madeley, Melanie C. Robert, Philip Vlaskovsky, Christobel Saunders
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Journal of Medical Radiation Sciences, Vol 70, Iss 3, Pp 218-228 (2023)
Druh dokumentu: article
ISSN: 2051-3909
2051-3895
DOI: 10.1002/jmrs.687
Popis: Abstract Introduction Impalpable breast lesions generally require image‐guided localisation for breast‐conserving surgery. A standard technique is to place a hook wire (HW) within the lesion. Radioguided occult lesion localisation using iodine seeds (ROLLIS) involves inserting a 4.5 mm iodine‐125 seed (seed) into the lesion. We hypothesised that a seed could be more precisely positioned in relation to the lesion than a HW and that this may be associated with a lower re‐excision rate. Methods Retrospective review of consecutive participant data from three ROLLIS RCT (ACTRN12613000655741) sites. Participants underwent preoperative lesion localisation (PLL) with seed or HW between September 2013 and December 2017. Lesion and procedural characteristics were recorded. Distances between (1) any part of the seed or thickened segment of the HW (‘TSHW’) and the lesion/clip (‘distance to device’ DTD) and (2) centre of the TSHW/seed and centre of the lesion/clip (device centre to target centre ‘DCTC’) were measured on immediate postinsertion mammograms. Pathological margin involvement and re‐excision rates were compared. Results A total of 390 lesions (190 ROLLIS and 200 HWL) were analysed. Lesion characteristics and guidance modality used were similar between groups. Ultrasound‐guided DTD and DCTC for seed were smaller than for HW (77.1% and 60.6%, respectively, P‐value
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