Mark J Dryden1, Basak E Dogan1, Patricia Fox2, Cuiyan Wang1,3, Dalliah M Black4, Kelly Hunt4, Wei Tse Yang1. 1. 1 Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350, Houston, TX 77030. 2. 2 Department of Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, TX. 3. 3 Shandong Medical Imaging Research Institute, Jinan, Shandong, China. 4. 4 Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX.
Abstract
OBJECTIVE: The objective of this study was to compare the potential influence of imaging variables on surgical margins after preoperative radioactive seed localization (RSL) and wire localization (WL) techniques. MATERIALS AND METHODS: A total of 565 women with 660 breast lesions underwent RSL or WL between May 16, 2012, and May 30, 2013. Patient age, lesion type (mass, calcifications, mass with associated calcifications, other), lesion size, number of seeds or wires used, surgical margin status (close positive or negative margins), and reexcision and mastectomy rates were recorded. RESULTS: Of 660 lesions, 127 (19%) underwent RSL and 533 (81%) underwent WL preoperatively. Mean lesion size was 1.8 cm in the RSL group and 1.8 cm in the WL group (p = 0.35). No difference in lesion type was identified in the RSL and WL groups (p = 0.63). RSL with a single seed was used in 105 of 127 (83%) RSLs compared with WL with a single wire in 349 of 533 (65%) WLs (p = 0.0003). The number of cases with a close positive margin was similar for RSLs (26/127, 20%) and WLs (104/533, 20%) (p = 0.81). There was no difference between the RSL group and the WL group in close positive margin status (20% each, p = 0.81), reexcision rates (20% vs 16%, respectively; p = 0.36), or mastectomy rates (6% each, p = 0.96). Lesions containing calcifications were more likely to require more than one wire (odds ratio [OR], 4.44; 95% CI, 2.8-7.0) or more than one seed (OR, 7.03; 95% CI, 1.6-30.0) when compared with masses alone (p < 0.0001). Increasing lesion size and the presence of calcifications were significant predictors of positive margins, whereas the use of more than one wire or seed was not (OR, 0.9; 95% CI, 0.5-1.5) (p = 0.75). CONCLUSION: Close positive margin, reexcision, and mastectomy rates remained similar in the WL group and RSL group. The presence of calcifications and increasing lesion size increased the odds of a close positive margin in both the WL and RSL groups, whereas the use of one versus more than one seed or wire did not.
OBJECTIVE: The objective of this study was to compare the potential influence of imaging variables on surgical margins after preoperative radioactive seed localization (RSL) and wire localization (WL) techniques. MATERIALS AND METHODS: A total of 565 women with 660 breast lesions underwent RSL or WL between May 16, 2012, and May 30, 2013. Patient age, lesion type (mass, calcifications, mass with associated calcifications, other), lesion size, number of seeds or wires used, surgical margin status (close positive or negative margins), and reexcision and mastectomy rates were recorded. RESULTS: Of 660 lesions, 127 (19%) underwent RSL and 533 (81%) underwent WL preoperatively. Mean lesion size was 1.8 cm in the RSL group and 1.8 cm in the WL group (p = 0.35). No difference in lesion type was identified in the RSL and WL groups (p = 0.63). RSL with a single seed was used in 105 of 127 (83%) RSLs compared with WL with a single wire in 349 of 533 (65%) WLs (p = 0.0003). The number of cases with a close positive margin was similar for RSLs (26/127, 20%) and WLs (104/533, 20%) (p = 0.81). There was no difference between the RSL group and the WL group in close positive margin status (20% each, p = 0.81), reexcision rates (20% vs 16%, respectively; p = 0.36), or mastectomy rates (6% each, p = 0.96). Lesions containing calcifications were more likely to require more than one wire (odds ratio [OR], 4.44; 95% CI, 2.8-7.0) or more than one seed (OR, 7.03; 95% CI, 1.6-30.0) when compared with masses alone (p < 0.0001). Increasing lesion size and the presence of calcifications were significant predictors of positive margins, whereas the use of more than one wire or seed was not (OR, 0.9; 95% CI, 0.5-1.5) (p = 0.75). CONCLUSION: Close positive margin, reexcision, and mastectomy rates remained similar in the WL group and RSL group. The presence of calcifications and increasing lesion size increased the odds of a close positive margin in both the WL and RSL groups, whereas the use of one versus more than one seed or wire did not.
Authors: James W Jakub; Richard J Gray; Amy C Degnim; Judy C Boughey; Mary Gardner; Charles E Cox Journal: Am J Surg Date: 2009-12-02 Impact factor: 2.565
Authors: M W Barentsz; M A A J van den Bosch; W B Veldhuis; P J van Diest; R M Pijnappel; A J Witkamp; H M Verkooijen Journal: Br J Surg Date: 2013-04 Impact factor: 6.939
Authors: Vilert A Loving; David B Edwards; Kevin T Roche; Joseph R Steele; Stephen A Sapareto; Stephanie C Byrum; Donald F Schomer Journal: AJR Am J Roentgenol Date: 2014-06 Impact factor: 3.959
Authors: Peter J Lovrics; Charlie H Goldsmith; Nicole Hodgson; David McCready; Gabriela Gohla; Colm Boylan; Sylvie Cornacchi; Michael Reedijk Journal: Ann Surg Oncol Date: 2011-04-30 Impact factor: 5.344
Authors: Neslihan Cabioglu; Kelly K Hunt; Aysegul A Sahin; Henry M Kuerer; Gildy V Babiera; S Eva Singletary; Gary J Whitman; Merrick I Ross; Frederick C Ames; Barry W Feig; Thomas A Buchholz; Funda Meric-Bernstam Journal: Ann Surg Oncol Date: 2007-01-28 Impact factor: 5.344
Authors: Janice S Sung; Valencia King; Cynthia M Thornton; Jennifer D Brooks; Charles W Fry; Mahmoud El-Tamer; Lawrence T Dauer; Edi Brogi; Jean M St Germain; Elizabeth A Morris Journal: Eur J Radiol Date: 2013-05-14 Impact factor: 3.528
Authors: Meena S Moran; Stuart J Schnitt; Armando E Giuliano; Jay R Harris; Seema A Khan; Janet Horton; Suzanne Klimberg; Mariana Chavez-MacGregor; Gary Freedman; Nehmat Houssami; Peggy L Johnson; Monica Morrow Journal: J Clin Oncol Date: 2014-02-10 Impact factor: 44.544
Authors: James O Murphy; Tracy-Ann Moo; Tari A King; Kimberly J Van Zee; Kristine A Villegas; Michelle Stempel; Anne Eaton; Jean M St Germain; Elizabeth Morris; Monica Morrow Journal: Ann Surg Oncol Date: 2013-08-14 Impact factor: 5.344