SAN ANTONIO –  In patients with nonpalpable invasive breast cancer or ductal carcinoma in situ (DCIS), there were no differences with respect to positive margins, patient’s pain perception, or duration of the surgical procedure between radioactive seed localization (RSL) and wire guided localization (WGL), according to a study presented at the 2016 San Antonio Breast Cancer Symposium (SABCS).1

The current standard method for locating nonpalpable breast lesions is wire guided localization (WGL); however, this approach is associated with several disadvantages, including inaccurate lesion localization, incomplete lesion removal, and subsequent reoperation. Therefore, researchers developed RSL as an alternative, more accurate approach.

To compare RSL and WGL, researchers enrolled 409 patients with nonpalpable invasive breast cancer or DCIS whose lesions were visible on ultrasound (ClinicalTrials.gov Identifier: NCT01901991). Participants were randomly assigned 1:1 to either of the 2 localization methods. Of note, there were significantly more patients with DCIS in the WGL group (P =.006).


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Results showed that RSL detected negative margins in 88.2% and positive margins in 11.8% compared with 86.7% and 13.3% with WGL, respectively (odds ratio [OR], 1.15; 95% CI, 0.63-2.10; P =.65).

Results were similar in the per-protocol analysis (OR, 1.17; 95% CI, 0.64-2.14; P = .62) and among only patients with invasive breast cancer (OR, 1.0; 95% CI, 0.53-1.89; P =.997).

Duration of the surgical procedure (P =.12) and weight of the excised specimen were also similar between the 2 arms. Regardless of whether patients received local anesthesia, there was no difference in pain perception.

In addition, there was no significant difference in the rate of complications (P =.89) or sentinel node identification rate between the 2 groups (P =1.00).

“Although were not able to detect any differences considering positive margins, patient’s pain perception, or duration of the surgical procedure between the two localization methods, RSL offers a major logistic advantage, as the seed localization can be done several days before surgery without any risk or discomfort for the patient, with a low proportion of patients needing additional localization,” explained Linnea Langhans, Rigshospitalet & Herlev Hospital, University of Copenhagen, Denmark.

Reference

1. Langhans L, Tvedskov TF, Klausen TL, et al. Radioactive seed localization versus wire guided localization of nonpalpable invasive and in situ breast cancer: A Danish multicenter randomized controlled trial. Paper presented at: 2016 San Antonio Breast Cancer Symposium; December 6-10, 2016; San Antonio, TX.