Fabio Corsi1, Luca Sorrentino2, Alessandra Sartani2, Daniela Bossi2, Rosella Amadori3, Manuela Nebuloni4, Marta Truffi5, Matteo Bonzini6, Diego Foschi7. 1. Surgery Division, Luigi Sacco Hospital, Via G. B. Grassi 74, Milan 20157, Italy; Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan 20157, Italy. Electronic address: fabio.corsi@unimi.it. 2. Surgery Division, Luigi Sacco Hospital, Via G. B. Grassi 74, Milan 20157, Italy. 3. Radiology Division, Luigi Sacco Hospital, Via G. B. Grassi 74, Milan 20157, Italy. 4. Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan 20157, Italy; Pathology Division, Luigi Sacco Hospital, Via G. B. Grassi 74, Milan 20157, Italy. 5. Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan 20157, Italy. 6. Centro Studi Epidemiologia e Medicina Preventiva, Department of Clinical and Experimental Medicine, Insubria University, Varese, Italy. 7. Surgery Division, Luigi Sacco Hospital, Via G. B. Grassi 74, Milan 20157, Italy; Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan 20157, Italy.
Abstract
BACKGROUND: Achieving clear margins with adequate resection volumes is one of the principal goals of breast-conserving surgery. The aim of our study was to compare preoperative localization using 2 different clips, radiopaque or sonographically visible, to reach this goal. METHODS: We reviewed 209 consecutive nonpalpable breast cancers that were treated with lumpectomy: 59 with radiopaque and 150 with sonographically visible clip positioned during biopsy procedure. In the former case, preoperative localization was performed with mammography and in the latter by ultrasonography. RESULTS: Clear margins were achieved in 80.4% of patients: 57.6% in the first and 89.3% in the second group (P < .0001; odds ratio, 7.6; 95% confidence interval, 3.4 to 17.2). By using sonographically visible clips, the re-excision rate has decreased from 42.4% to 10.7%, (P < .0001), and resections resulted smaller with average calculated resection ratio of 3.54 vs. 5.08 (P = .03). CONCLUSIONS: Preoperative localization using a sonographically visible clip allows a more tailored breast-conserving surgery and reduces the re-excision rate.
BACKGROUND: Achieving clear margins with adequate resection volumes is one of the principal goals of breast-conserving surgery. The aim of our study was to compare preoperative localization using 2 different clips, radiopaque or sonographically visible, to reach this goal. METHODS: We reviewed 209 consecutive nonpalpable breast cancers that were treated with lumpectomy: 59 with radiopaque and 150 with sonographically visible clip positioned during biopsy procedure. In the former case, preoperative localization was performed with mammography and in the latter by ultrasonography. RESULTS: Clear margins were achieved in 80.4% of patients: 57.6% in the first and 89.3% in the second group (P < .0001; odds ratio, 7.6; 95% confidence interval, 3.4 to 17.2). By using sonographically visible clips, the re-excision rate has decreased from 42.4% to 10.7%, (P < .0001), and resections resulted smaller with average calculated resection ratio of 3.54 vs. 5.08 (P = .03). CONCLUSIONS: Preoperative localization using a sonographically visible clip allows a more tailored breast-conserving surgery and reduces the re-excision rate.
Authors: Jeffery M Chakedis; Annie Tang; Gillian E Kuehner; Brooke Vuong; Liisa L Lyon; Lucinda A Romero; Benjamin M Raber; Melinda M Mortenson; Veronica C Shim; Nicole M Datrice-Hill; Jennifer R McEvoy; Vignesh A Arasu; Dorota J Wisner; Sharon B Chang Journal: Ann Surg Oncol Date: 2021-08-26 Impact factor: 5.344