A Multicentered, Randomized, Controlled Trial Comparing Radioguided Seed Localization to Standard Wire Localization for Nonpalpable, Invasive and in situ Breast Carcinomas

Abstract

In contrast to other trials positive margin and reoperation rates were similar for RSL and WL. However, for RSL operative times were shorter, and the technique was preferred by surgeons, making it an acceptable method for localization.

Radioactive Seed Localization for Nonpalpable Breast Lesions in a Community Hospital Setting

“…5, No. 1;2016 having positive margins (all p-values greater than 0.25). There were also no statistically significant differences between RSL and WL on minimum negative margin (in mm), or the total time (in days) from the initial biopsy to breast conservative surgery.…”

“…5, No. 1;2016 the volume of the operative bed. The t-test was performed to compare between RSL and WL regarding the minimum negative margin, the total treatment time from the initial biopsy to the date of the breast conservative surgery, and the amount of breast tissue removed by the weight of the specimen and by the volume of the operative bed as determined on the radiotherapy planning CT images.…”

“…5, No. 1;2016 transported to the nuclear medicine department for appropriate disposition. The radiation safety officer also needed to provide the appropriate training of all of the individuals involved in handling the iodine-125 marker seeds and caring for patients with an implanted radioactive source.…”

ROLL versus RSL: toss of a coin?

“…Great variation exists in the radiation dose administered for ROLL, with the literature quoting anywhere between 5 and 123 MBq, [12,13] whilst for RSL it is between 3.7 and 10.7 MBq [14,15]. ROLL requires localization to be performed within 24 h of surgery due to the short 6 h half-life of 99m Tc-labelled colloid and RSL typically is performed 0-5 days prior to surgery [7,[14][15][16][17]. In the primary systemic therapy (PST) setting RSL can be undertaken several months before surgery because the half-life of 125 I is 60 days [18].…”

“…Concern has been raised at the issue of migration and subsequent loss of inserted seeds, but clinically relevant seed migration is rare and has been reported in \1 % of RSL procedures [19]. In the eight published studies [7,[14][15][16][17][18]20] on RSL, 2 studies [11,17] have failed to demonstrate 100 % successful intraoperative localization for RSL, with failure rates of 2 % [11] and 7.9 %. [17] The largest published series of RSL with 978 patients recorded a 100 % successful localization rate [7].…”