Intra-operative ultrasound versus wire-guided localization in the surgical management of non-palpable breast cancer

Morris, Owen James; Knight, Veronica; Logan, David A.

doi:10.3233/bd-140369

Cited by 4 publications

(3 citation statements)

References 63 publications

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“…Recently, the technique of intraoperative US has been used widely, which was a reliable and helpful tool for NBC. However, US guidance and excision of the lesion cannot be performed simultaneously and there is no guide wire to see or feel during the procedure, it may be also difficult for a surgeon to define the tumor margins accurately, especially for women with large breasts and deeply seated lesions …”

Section: Discussionmentioning

confidence: 99%

Indocyanine green fluorescence-guided lumpectomy of nonpalpable breast cancer versus wire-guided excision: A randomized clinical trial

Meng

Guo

2019

Breast J

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The use of wire localization (WL) for excisions of nonpalpable breast cancer (NBC) has several disadvantages. The purpose of this study was to evaluate the use of indocyanine green‐guided nonpalpable breast cancer lesion localization (INBCL) and to compare it with WL. A total of 62 patients with a preoperative histological diagnosis of NBC lesions that could be visualized with ultrasound and mammography were randomized to INBCL or WL. Patients with preoperatively diagnosed primary ductal carcinoma in situ and multifocal disease were excluded from the study. Significance was considered at P < 0.05. Of all 62 excision, 32 (51.6%) were guided by INBCL and 30 (48.4%) by WL. Both techniques resulted in 100% retrieval of the lesions. The rate of clear margins was significantly higher in the INBCL group (87.5%; 28/32) compared to the WL (63.3%, 19/30) (P = 0.026), reducing the requirement of re‐excision. When results of the excised tissue are taken into account, the mean volume of the INBCL specimen was 56 cm3 less than that of the WL group, although this was not significantly different (P = 0.058). INBCL for NBCs was more accurate than WL, because it optimized the surgeon's ability to obtain clear margins. A smaller volume of the tissue may be excised by using INBCL technique. Therefore INBCL is an attractive alternative to WL.

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Section: Discussionmentioning

confidence: 99%

Indocyanine green fluorescence-guided lumpectomy of nonpalpable breast cancer versus wire-guided excision: A randomized clinical trial

Meng

Guo

2019

Breast J

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“…In order to guide the surgeon for making a surgical margin around the breast tumor, repeat imaging with US probe in the wound is needed, which is another weak point for US guidance. 19 ICG fluorescence has been used as a tracer for many years and has demonstrated excellent safety profile for clinical use. 7,20 There are theoretical and practical advantages about the fluorescence navigation technique as a guidance to the surgical excision of NBCs.…”

Section: Discussionmentioning

confidence: 99%

“…In order to guide the surgeon for making a surgical margin around the breast tumor, repeat imaging with US probe in the wound is needed, which is another weak point for US guidance. 19…”

Section: Discussionmentioning

confidence: 99%

Indocyanine Green Fluorescence–Guided Lumpectomy of Nonpalpable Breast Cancer Versus Ultrasound-Guided Excision

Guo

Zhang

et al. 2022

Surg Innov

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Purpose The purpose of this study was to evaluate the use of indocyanine green–guided nonpalpable breast cancer lesion localization (INBCL) and to compare it with ultrasound localization (US). Methods We retrospectively reviewed 78 consecutive patients undergoing breast-conserving surgery for nonpalpable breast cancer (NBC). Of all 78 excisions, 42 cases were guided by INBCL and 36 by US. Results The rate of clear margins was 90.5% (38/42) in the INBCL group compared to the 83.3% (30/36) in the US ( P = .548). A comparison of the margins at first excision for both INBCL and US, in the INBCL series, 92.9% (39/42) of cases had a margin less than 5 mm, whereas for US series, it was 72.2% (26/36) ( P = .033). When results of the excised tissue are taken into account, the mean specimen volume for INBCL was 58 cm3, but for US it was 73 cm3, with difference in mean volume being 15 cm3 ( P = .062). Conclusions INBCL for NBCs was more accurate than US because a smaller volume of the tissue may be excised by using the technique, without compromising margin status in nonpalpable lesions.

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Ultrasound-guided breast-conserving surgery for early-stage palpable and nonpalpable invasive breast cancer: decreased excision volume at unchanged tumor-free resection margin

Slijkhuis

Noorda

Zaag-Loonen

et al. 2016

Breast Cancer Res Treat

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Ultrasound guidance (USG) during breast-conserving surgery improves tumor-free surgical resection margins. The objective of this study was to evaluate whether USG reduces resection volumes without compromising margin status. 134 patients with palpable or nonpalpable T1-2N0-1 invasive breast cancer were treated with USG and compared with a historical reference control group (CON) consisting of palpation-guided (PAG) or wire-guided localization (WIG) breast-conserving surgery. Primary outcomes were excess resection volume and clear margin status, and secondary outcome was re-excision rate. 66 patients underwent USG. In the CON group (n = 68), PAG was performed in 24 (35 %) and WIG in 44 (64 %) patients. Median excision volume [39 (IQR 20-66) vs 56 (38-94) cm(3); p = 0.001] and median calculated resection ratio [1.7 (1.0-2.9) vs 2.8 (1.4-4.6) (p = 0.005)] were significantly smaller in the USG than in the CON group. Median minimal distance to the resection margin [4 mm (IQR 2-5 mm) vs 2 mm (1-4 mm), p = 0.004] was significantly larger. Clear resection margins were achieved in 58 of the USG patients (88 %) and in 58 of the CON patients (86 %) (p = 0.91); this was true in patients with palpable as well as nonpalpable lesions. Reexcision was needed in 6.1 and 7.2 % respectively. Relative risk for re-excision in the USG group was 0.82 (95 % CI 0.23-2.93). In patients with palpable and nonpalpable breast cancers, USG allows for lower excision volume and reduced resection of healthy breast tissue, without increased re-excision rate.

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Intra-operative ultrasound versus wire-guided localization in the surgical management of non-palpable breast cancer

Cited by 4 publications

References 63 publications

Indocyanine green fluorescence-guided lumpectomy of nonpalpable breast cancer versus wire-guided excision: A randomized clinical trial

Indocyanine green fluorescence-guided lumpectomy of nonpalpable breast cancer versus wire-guided excision: A randomized clinical trial

Indocyanine Green Fluorescence–Guided Lumpectomy of Nonpalpable Breast Cancer Versus Ultrasound-Guided Excision

Ultrasound-guided breast-conserving surgery for early-stage palpable and nonpalpable invasive breast cancer: decreased excision volume at unchanged tumor-free resection margin

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