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Bracketed radioactive seed localization vs bracketed wire-localization in breast surgery.

Monica Da Silva1, Jessica Porembka2, Ali A Mokdad1

  • 1Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.

The Breast Journal
|July 15, 2017
PubMed
Summary

Bracketed radioactive seed localization (bRSL) offers an alternative to bracketed wire localization (bWL) for extensive breast lesions. bRSL demonstrated reduced re-excision and mastectomy rates with comparable specimen volumes.

Keywords:
bracketed localizationbreastradioactive seed localizationre-excisionwire localization

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Area of Science:

  • Radiology
  • Surgical Oncology
  • Breast Imaging

Background:

  • Bracketed localization techniques are crucial for excising extensive breast lesions.
  • Traditional bracketed wire localization (bWL) may lead to suboptimal outcomes.

Purpose of the Study:

  • To compare the efficacy of bracketed radioactive seed localization (bRSL) versus bracketed wire localization (bWL).
  • To evaluate margin adequacy, re-operation rates, and specimen volumes between bRSL and bWL.

Main Methods:

  • Retrospective review of patients undergoing bracketed breast procedures.
  • Comparison of surgical outcomes including re-excision rates, specimen volumes, and mastectomy rates.
  • Statistical analysis using Wilcoxon rank-sum, chi-square tests, and multivariable logistic regression.

Main Results:

  • Patients undergoing bWL had a 3.9 times higher likelihood of re-excision compared to bRSL.
  • No significant difference in initial or total specimen volumes between bRSL and bWL.
  • Mastectomy rates were significantly lower in the bRSL group (7%) compared to the bWL group (24%).

Conclusions:

  • Bracketed radioactive seed localization (bRSL) is a viable alternative to bracketed wire localization (bWL) for extensive breast lesions.
  • bRSL is associated with decreased re-excision and mastectomy rates.
  • bRSL achieves comparable specimen volumes to bWL.