The Evolving Role of Radiofrequency Guided Localisation in Breast Surgery: A Systematic Review

Abstract

Wire-guided localisation (WGL) has been the gold-standard for localising non-palpable breast lesions before excision. Due to its drawbacks, various wireless alternatives have been developed, including LOCalizer™, which is based on radio-frequency identification (RFID) technology. In this systematic review, we consulted EMBASE, Medline and PubMed databases using appropriate search terms regarding the use of RFID technology in the localisation of occult breast lesions. Retrospective and prospective studies were included if they quoted the number of patients, rate of successful placement, retrieval rate, margin positivity rate and the re-excision rate. In addition, studies comparing RFID to WGL were also included and analysed separately. Seven studies were included in this systematic review spanning 1151 patients and 1344 tags. The pooled deployment rate was 99.1% and retrieval rate was 100%. Re-excision rate was 13.9%. One complication was identified. Two studies compared RFID with WGL (128 vs. 282 patients respectively). For both techniques the re-excision rate was 15.6% (20/128 vs. 44/282 respectively, p value is 0.995). Based on our review, LOCalizer™ is safe and non-inferior to WGL in terms of successful localisation and re-excision rates. However, further research is required to assess the cost effectiveness of this approach and its impact on the aesthetic outcome compared with WGL and other wire free technologies to better inform decision making in service planning and provision.

Patient Satisfaction with Radio-Frequency Identification (RFID) Tag Localization Compared with Wire Localization for Nonpalpable Breast Lesions: the RFID Trial

“…For WL, Davey et al reported a positive margin rate of 20.1% and a surgical re-excision rate of 17.3% in a meta-analysis involving 24 randomized controlled trials [21]. In a review by Tayeh et al, the surgical re-excision rate for RFID localization was 13.9% [22].…”

“…Two on-going prospective, controlled studies assessing RFID localization are currently underway, but their results are not yet available [10,11]. All these studies, most included in a recent meta-analysis, have concluded that RFID tags are a potential alternative to hook wire and should be considered for localizing non-palpable breast lesions [12].…”

Radiofrequency Identification—RFID using LOCalizer-Tag in Non-palpable Breast Lump

“…Magseed is similar to the RFID system but is not able to offer the exact distance from the marker in mm, because it is based only on acoustic and visive information about the signal strength [12]. Both the systems are promising, and many studies encouraged the adoption of RFID breast localization for NPBL, particularly [15][16][17]. Wazir et al [18] reported the experience of a double tag placement.…”

Evolution of localization methods for non-palpable breast lesions: a literature review from a translational medicine perspective

“…A systematic review published in 2021 by Tayeh et al involved 1,151 patients and 1,344 RFID tags. The review concluded that the LOCalizer™ system is a valid, safe, and effective alternative to WGL ( 99 ). A recent study by Parisi et al showed that combined LOCalizer™ and US localization technique had superior oncological outcomes as compared to LOCalizer™ alone ( 23 ).…”

“…It utilizes an introducer needle that is wider than the introducer needles of Magseed ® and Savi Scout ® . Therefore, deployment within dense breast tissue could potentially be difficult ( 99 ). Furthermore, the RFID system has similar limitations as radar technology, such as dislocation of the marker during insertion, hematoma, and limited detection range ( 100 ).…”