Abstract
Purpose
Use of a wire to localize a non-palpable breast lesion for surgery is standard but archaic. We sought to evaluate a new radiofrequency localization system (RFLS) as an effective, non-radioactive alternative to the wire.
Methods
Patients who required surgical excision of a non-palpable breast lesion were consented for the study. Patients underwent localization with a radiofrequency Tag and surgical removal guided by the handheld LOCalizer probe. The primary study endpoint was successful placement and retrieval of the Tag, and secondary endpoints included marker migration; days prior to surgery of Tag insertion; patient, radiologist, and surgeon experience; distance of Tag from skin; and positive margin and re-excision rates for cancer.
Results
Fifty patients had successful placement and retrieval of the radiofrequency Tag. Likert questionnaire data revealed that most patients thought the procedure went smoothly and was easier than expected. Radiologists and surgeons thought that the Tag was as reliable as the wire. Of the 33 patients who had surgery for in situ or invasive cancer, one had a positive margin on final pathology (3%) and two underwent re-excision (6%).
Conclusions
Data from this pilot study suggest that the RFLS is an effective localization system for non-palpable breast lesions intended for surgical removal. Unlike most other technologies, the LOCalizer probe detects distance from the Tag, and this unique feature may have contributed to the low positive margin rate seen in this study. The RFLS appears to offer advantages over current localization procedures and should be explored as an alternative to wire. ClinicalTrials.gov Identifier: NCT03202472.
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Abbreviations
- RFLS:
-
Radiofrequency identification localization system
- WL:
-
Wire localization
- RSL:
-
Radioactive seed localization
- RFID:
-
Radiofrequency identification
- FDA:
-
Food and Drug Administration
References
Leeming R, Madden M, Levy L (1993) An improved technique for needle localized biopsies of the breast. Surg Gynecol Obstet 177:84–86
Greenlee JA, Gubler KD, Goepfert CJ, Ragland JJ (1995) Surgical margins after needle-localization breast biopsy. Am J Surg 170(6):643–645
Jones MK, Vetto JT, Pommier RF, Thurmond AS, Woltering EA (1994) An improved method of needle localized biopsy of nonpalpable lesions of the breast. J Am Coll Surg 178:548–552
Shetty MK (2010) Presurgical localization of breast abnormalities: an overview and analysis of 202 cases. Indian J Surg Oncol 1(4):278–283
Jackman RJ, Marzoni FJ (1997) Needle localized breast biopsy. Why do we fail?. Radiology 204(3):677–684
Abrahamson PE, Dunlap LA, Amarnoo MA, Schell MJ, Braeuning MP, Pisano ED (2003) Factors predicting successful needle-localized breast biopsy. Acad Radiol 10(6):601–606
Davis PS, Wechsler RJ, Feig SA, March DE (1988) Migration of breast biopsy localization wire. AJR Am J Roentgenol 150:787–788
Gray RJ, Salud C, Nguyen K, Dauway E, Friedland J, Berman C, Peltz E, Whitehead G, Cox CE (2001) Randomized prospective evaluation of a novel technique for biopsy or lumpectomy of nonpalpable breast lesions: radioactive seed versus wire localization. Ann Surg Oncol 8(9):711–715
McGhan LJ, McKeever SC, Pockaj BA, Wasif N, Giurescu ME, Walton HA, Gray RJ (2011) Radioactive seed localization for nonpalpable breast lesions: review of 1,000 consecutive procedures at a single institution. Ann Surg Oncol 18:3096–3101
Gray RJ, Pockaj BA, Karstaedt PJ, Roarke MC (2004) Radioactive seed localization of nonpalpable breast lesions is better than wire localization. Am J Surg 188(4):377–380
Dryden MJ, Dogan BE, Fox P, Wang C, Black DM, Hunt K, Yang WT (2016) Imaging factors that influence surgical margins after preoperative 125I radioactive seed localization of breast lesions: comparison with wire localization. AJR 206(5):1112–1118
Hughes JH, Mason MC, Gray RJ et al (2008) A multi-site validation trial of radioactive seed localization as an alternative to wire localization. Breast J 14(2):153–157
Price ER, Khoury AL, Esserman LJ, Joe BN, Alvarado MD (2018) Initial clinical experience with an inducible magnetic seed system for preoperative breast lesion localization. AJR 210(4):913–917
Harvey JR, Lim Y, Murphy J, Howe M, Morris J, Goyal A, Maxwell AJ (2018) Safety and feasibility of breast lesion localization using magnetic seeds (Magseed): a multi-centre, open-label cohort study. Breast Cancer Res Treat 169(3):531–536
Mango VL, Wynn RT, Feldman S et al (2017) Beyond wires and seeds: reflector-guided breast lesion localization and excision. Radiology 284(2):365–371
Jadeja PH, Mango V, Patel S, Friedlander L, Desperito E, Ayala-Bustamante E, Wynn R, Chen-Seetoo M, Taback B, Feldman S, Ha R (2018) Utilization of multiple SAVI SCOUT surgical guidance system reflectors in the same breast: a single-institution feasibility study. Breast J 24(4):531–534
Patel SN, Mango VL, Jadeja P, Friedlander L, Desperito E, Wynn R, Feldman S, Ha R (2018) Reflector-guided breast tumor localization versus wire localization for lumpectomies: a comparison of surgical outcomes. Clin Imaging 47:14–17
Cox CE, Russell S, Prowler V, Carter E, Beard A, Mehindru A, Blumencranz P, Allen K, Portillo M, Whitworth P, Funk K, Barone J, Norton D, Schroeder J, Police A, Lin E, Combs F, Schnabel F, Toth H, Lee J, Anglin B, Nguyen M, Canavan L, Laidley A, Warden MJ, Prati R, King J, Shivers SC (2016) A prospective, single arm, multi-site, clinical evaluation of a nonradioactive surgical guidance technology for the location of nonpalpable breast lesions during excision. Ann Surg Oncol 23(10):3168–3174
Mango V, Ha R, Gomberawalla A, Wynn R, Feldman S (2016) Evaluation of the SAVI SCOUT surgical guidance system for localization and excision of nonpalpable breast lesions: a feasibility study. AJR Am J Roentgenol 207(4):W69–W72
Cox CE, Garcia-Henriquez N, Glancy MJ, Whitworth P, Cox JM, Themar-Geck M, Prati R, Jung M, Russell S, Appleton K, King J, Shivers SC (2016 Jun) Pilot study of a new nonradioactive surgical guidance technology for locating nonpalpable breast lesions. Ann Surg Oncol 23(6):1824–1830
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DiNome, M.L., Kusske, A.M., Attai, D.J. et al. Microchipping the breast: an effective new technology for localizing non-palpable breast lesions for surgery. Breast Cancer Res Treat 175, 165–170 (2019). https://doi.org/10.1007/s10549-019-05143-w
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DOI: https://doi.org/10.1007/s10549-019-05143-w