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Breast surgery techniques: preoperative bracketing wire localization by surgeons.

Hans C Burkholder1, Laura E Witherspoon, R Phillip Burns

  • 1Department of Surgery, University of Tennessee, College of Medicine, Chattanooga Unit, Chattanooga, Tennessee, USA.

The American Surgeon
|July 31, 2007
PubMed
Summary
This summary is machine-generated.

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Multiple wire localization for breast biopsies can reduce tissue removal in malignant disease without impacting margin status or re-excision rates. Surgeon experience influences technique and outcomes, with high-volume surgeons optimizing breast-conserving procedures.

Area of Science:

  • Radiology
  • Surgical Oncology
  • Breast Imaging

Background:

  • Image-guided breast surgery, including preoperative wire localization, is increasingly performed by surgeons.
  • The clinical benefits of using single versus multiple wires for localization have not been well-established.

Purpose of the Study:

  • To compare clinical outcomes of single versus multiple wire placements for breast biopsies.
  • To evaluate the impact of surgeon experience on wire localization techniques and outcomes.

Main Methods:

  • Retrospective analysis of 489 wire-localized breast biopsies over 29 months, using stereotactic and ultrasound guidance.
  • Comparison of margin status, re-excision rates, and tissue volume removed between single and multiple wire placements, controlling for tumor stage.
  • Analysis of outcomes based on surgeon case volume (low, medium, high).

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Main Results:

  • Neither margin status nor re-excision rates differed based on the number of wires placed.
  • Multiple wire placement was associated with increased tissue removal in benign disease but decreased removal in malignant disease (stages 1-4).
  • High-volume surgeons were more likely to use multiple wires and perform breast-conserving procedures upon re-excision; low-volume surgeons had higher re-excision rates.

Conclusions:

  • Multiple wire localization can reduce tissue volume removed in malignant breast disease without compromising margins or increasing re-excision.
  • Surgeon experience positively impacts quality outcomes, including definitive procedures and breast conservation.
  • Multiple wire techniques may be optimized by experienced surgeons to improve tissue-sparing outcomes.