Use of an intraoperative ultrasonography-guided localization and tissue fixation device demonstrates less margin positivity during breast-conserving surgery for invasive breast cancer than standard preoperative needle-wire localization

A retrospective comparative analysis in a consecutively treated case series

Stephen P. Povoski, Rafael E Jimenez, Wenle P. Wang

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose To retrospectively compare 2 methods of pre-resection, image-guided tumor localization - preoperative needle-wire localization (PNWL) and intraoperative ultrasonography-guided localization and tissue fixation (IUGLTF) - for patients with invasive breast cancer at the time of breast-conserving surgery (BCS). Patients and Methods We identified 118 cases in which image-guided localization was required for nonpalpable and questionably palpable tumors from a series of 204 consecutive invasive breast cancers treated by BCS. We defined a positive margin as tumor at the inked surface. We defined a close margin as tumor within 1 mm or less of the inked surface. Results Of those 118 cases requiring pre-resection, image-guided localization, 54 patients underwent PNWL and 64 underwent IUGLTF placement. A positive margin was identified in 6 of 54 (11.1%) undergoing PNWL compared with 1 of 64 (1.6%) undergoing IUGLTF (P =.046). A positive or close margin was identified in 9 of 54 (16.7%) undergoing PNWL compared with 3 of 64 (4.7%) undergoing IUGLTF (P =.032). The mean volume and mean weight of the BCS specimens were not different in the 2 groups. Conclusion Based on the finding of less margin positivity associated with the IUGLTF technique than the PNWL technique, we believe that the use of an IUGLTF device by surgeons during BCS could be highly advantageous in the surgical management of nonpalpable and questionably palpable invasive breast cancers.

Original languageEnglish (US)
Pages (from-to)46-52
Number of pages7
JournalClinical Breast Cancer
Volume14
Issue number1
DOIs
StatePublished - Feb 2014
Externally publishedYes

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Tissue Fixation
Segmental Mastectomy
Needles
Ultrasonography
Breast Neoplasms
Equipment and Supplies
Neoplasms
Weights and Measures

Keywords

  • Breast cancer
  • Breast-conserving surgery
  • Image-guided
  • Intraoperative
  • Localization

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

@article{673bd3083e31450faf5d272b8764162e,
title = "Use of an intraoperative ultrasonography-guided localization and tissue fixation device demonstrates less margin positivity during breast-conserving surgery for invasive breast cancer than standard preoperative needle-wire localization: A retrospective comparative analysis in a consecutively treated case series",
abstract = "Purpose To retrospectively compare 2 methods of pre-resection, image-guided tumor localization - preoperative needle-wire localization (PNWL) and intraoperative ultrasonography-guided localization and tissue fixation (IUGLTF) - for patients with invasive breast cancer at the time of breast-conserving surgery (BCS). Patients and Methods We identified 118 cases in which image-guided localization was required for nonpalpable and questionably palpable tumors from a series of 204 consecutive invasive breast cancers treated by BCS. We defined a positive margin as tumor at the inked surface. We defined a close margin as tumor within 1 mm or less of the inked surface. Results Of those 118 cases requiring pre-resection, image-guided localization, 54 patients underwent PNWL and 64 underwent IUGLTF placement. A positive margin was identified in 6 of 54 (11.1{\%}) undergoing PNWL compared with 1 of 64 (1.6{\%}) undergoing IUGLTF (P =.046). A positive or close margin was identified in 9 of 54 (16.7{\%}) undergoing PNWL compared with 3 of 64 (4.7{\%}) undergoing IUGLTF (P =.032). The mean volume and mean weight of the BCS specimens were not different in the 2 groups. Conclusion Based on the finding of less margin positivity associated with the IUGLTF technique than the PNWL technique, we believe that the use of an IUGLTF device by surgeons during BCS could be highly advantageous in the surgical management of nonpalpable and questionably palpable invasive breast cancers.",
keywords = "Breast cancer, Breast-conserving surgery, Image-guided, Intraoperative, Localization",
author = "Povoski, {Stephen P.} and Jimenez, {Rafael E} and Wang, {Wenle P.}",
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T1 - Use of an intraoperative ultrasonography-guided localization and tissue fixation device demonstrates less margin positivity during breast-conserving surgery for invasive breast cancer than standard preoperative needle-wire localization

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AU - Jimenez, Rafael E

AU - Wang, Wenle P.

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N2 - Purpose To retrospectively compare 2 methods of pre-resection, image-guided tumor localization - preoperative needle-wire localization (PNWL) and intraoperative ultrasonography-guided localization and tissue fixation (IUGLTF) - for patients with invasive breast cancer at the time of breast-conserving surgery (BCS). Patients and Methods We identified 118 cases in which image-guided localization was required for nonpalpable and questionably palpable tumors from a series of 204 consecutive invasive breast cancers treated by BCS. We defined a positive margin as tumor at the inked surface. We defined a close margin as tumor within 1 mm or less of the inked surface. Results Of those 118 cases requiring pre-resection, image-guided localization, 54 patients underwent PNWL and 64 underwent IUGLTF placement. A positive margin was identified in 6 of 54 (11.1%) undergoing PNWL compared with 1 of 64 (1.6%) undergoing IUGLTF (P =.046). A positive or close margin was identified in 9 of 54 (16.7%) undergoing PNWL compared with 3 of 64 (4.7%) undergoing IUGLTF (P =.032). The mean volume and mean weight of the BCS specimens were not different in the 2 groups. Conclusion Based on the finding of less margin positivity associated with the IUGLTF technique than the PNWL technique, we believe that the use of an IUGLTF device by surgeons during BCS could be highly advantageous in the surgical management of nonpalpable and questionably palpable invasive breast cancers.

AB - Purpose To retrospectively compare 2 methods of pre-resection, image-guided tumor localization - preoperative needle-wire localization (PNWL) and intraoperative ultrasonography-guided localization and tissue fixation (IUGLTF) - for patients with invasive breast cancer at the time of breast-conserving surgery (BCS). Patients and Methods We identified 118 cases in which image-guided localization was required for nonpalpable and questionably palpable tumors from a series of 204 consecutive invasive breast cancers treated by BCS. We defined a positive margin as tumor at the inked surface. We defined a close margin as tumor within 1 mm or less of the inked surface. Results Of those 118 cases requiring pre-resection, image-guided localization, 54 patients underwent PNWL and 64 underwent IUGLTF placement. A positive margin was identified in 6 of 54 (11.1%) undergoing PNWL compared with 1 of 64 (1.6%) undergoing IUGLTF (P =.046). A positive or close margin was identified in 9 of 54 (16.7%) undergoing PNWL compared with 3 of 64 (4.7%) undergoing IUGLTF (P =.032). The mean volume and mean weight of the BCS specimens were not different in the 2 groups. Conclusion Based on the finding of less margin positivity associated with the IUGLTF technique than the PNWL technique, we believe that the use of an IUGLTF device by surgeons during BCS could be highly advantageous in the surgical management of nonpalpable and questionably palpable invasive breast cancers.

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