Radioactive Seed Localization Versus Wire Localization for Nonpalpable Breast Lesions: A Two-Year Initial Experience at a Large Community Hospital

Ann Surg Oncol. 2018 Jan;25(1):131-136. doi: 10.1245/s10434-017-6102-1. Epub 2017 Nov 13.

Abstract

Background: Radioactive seed localization (RSL) is a safe and effective alternative to wire localization (WL) for nonpalpable breast lesions. While several large academic institutions currently utilize RSL, few community hospitals have adopted this technique.

Objective: The aim of this study was to examine the experience of RSL versus WL at a large community hospital.

Methods: A retrospective chart review of patients who underwent RSL or WL for breast-conserving surgery from 1 November 2013 to 31 November 2015.

Results: The total number of lesions examined was 382. RSL was utilized in 205 (54%) lesions, with 187 undergoing single RSL, while WL was used in 155 (40%) lesions, with 109 undergoing single WL; both techniques were used in 22 (6%) lesions. Pathology was benign in 142 (48%) lesions, with 93 RSLs and 49 WLs. For malignant lesions, mean specimen size was 36.3 g for single RSL and 35.9 g for single WL (p = 0.904). Re-excision for margin clearance was required for 16 (17%) malignant lesions in the RSL group and 10 (17%) in the WL group (p = 0.954). For malignant lesions, mean operating room time was 86 min for single RSL versus 70 min for single WL (p = 0.014).

Conclusions: The use of RSL is a viable option in the community setting, with several benefits over WL. While operative times were slightly longer with RSL, there was no difference in specimen size or re-excision rate for malignant lesions.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery*
  • Carcinoma, Ductal, Breast / diagnostic imaging*
  • Carcinoma, Ductal, Breast / secondary
  • Carcinoma, Ductal, Breast / surgery*
  • Carcinoma, Intraductal, Noninfiltrating / diagnostic imaging*
  • Carcinoma, Intraductal, Noninfiltrating / secondary
  • Carcinoma, Intraductal, Noninfiltrating / surgery*
  • Female
  • Fiducial Markers*
  • Hospitals, Community
  • Humans
  • Lymphatic Metastasis
  • Margins of Excision
  • Mastectomy, Segmental
  • Middle Aged
  • Operative Time
  • Radioisotopes
  • Reoperation
  • Retrospective Studies
  • Tumor Burden

Substances

  • Radioisotopes