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The effect of multiple wire localization in breast conservation.

Michelle M Fillion1, Emily Anne Black, Kathleen B Hudson

  • 1University of Tennessee Medical Center, Department of Surgery, 1924 Alcoa Highway, Knoxville, TN 37920, USA. michellefillionweeden@gmail.com

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|May 2, 2012
PubMed
Summary

Single hooked needle localization (SH) for nonpalpable breast lesions resulted in fewer positive margins and reoperations compared to flanking hooked needle localization (FH). SH is associated with better surgical outcomes in breast conservation therapy.

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Radiology

Background:

  • Surgical techniques for breast conservation therapy (BCT) vary.
  • Accurate localization of nonpalpable breast lesions is crucial for successful BCT.

Purpose of the Study:

  • To compare the efficacy of single (SH) versus flanking (FH) hooked needle localization wires for nonpalpable breast lesions.
  • To evaluate differences in margin status, reoperation rates, and specimen characteristics between SH and FH techniques.

Main Methods:

  • Retrospective review of 201 female patients with biopsy-proven breast cancer (DCIS or invasive) from 2004-2008.
  • Comparison of outcomes including margin status, reoperation, completion mastectomy, lesion size, and specimen volume between SH and FH groups.

Main Results:

  • The single hooked needle (SH) technique was used in 122 patients (61%), while the flanking hooked needle (FH) technique was used in 79 patients (39%).
  • SH group: 18% positive margins, 25% reoperations. FH group: 25% positive margins, 44% reoperations (P=0.039 and P=0.0037, respectively).
  • Average lesion size was 1.5 cm for SH vs. 2.85 cm for FH (P=0.0001); average specimen volume was 137 cm³ for SH vs. 188 cm³ for FH (P=0.006). Positive margins correlated with lesion size, not excised volume.

Conclusions:

  • The flanking hooked needle (FH) technique is associated with a higher rate of positive margins, reoperations, and completion mastectomies compared to the single hooked needle (SH) technique.
  • Lesion size, not specimen volume, is a significant factor associated with positive margins.
  • Single hooked needle localization may offer superior outcomes in breast conservation therapy for nonpalpable lesions.