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Related Experiment Video

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Breast conserving surgery for extensive DCIS using multiple radioactive seeds.

N N Y Janssen1, R F D van la Parra2, C E Loo3

  • 1Department of Radiation Oncology, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.

European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
|December 15, 2017
PubMed
Summary
This summary is machine-generated.

Using multiple radioactive iodine (125I) seeds for radioactive seed localization (RSL) in extensive ductal carcinoma in situ (eDCIS) may reduce positive margins and re-operations during breast conserving surgery (BCS). This approach offers improved outcomes for patients with large eDCIS lesions.

Keywords:
Breast conserving surgeryExtensive DCISNon-palpable breast cancerRadioactive seed localization

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Radiology

Background:

  • Breast conserving surgery (BCS) presents challenges for extensive ductal carcinoma in situ (eDCIS), often leading to positive resection margins.
  • Radioactive seed localization (RSL) using iodine-125 (125I) seeds can delineate large eDCIS areas for surgical removal.

Purpose of the Study:

  • To compare the efficacy of single versus multiple 125I seeds in RSL for BCS in patients with eDCIS.
  • To evaluate the impact of seed number on positive resection margin and re-operation rates.

Main Methods:

  • Retrospective analysis of patients with eDCIS (≥3.0 cm) undergoing single or multiple-seed RSL between 2008-2016.
  • Comparison of patient, tumor, and surgical characteristics between the two RSL groups.
  • Primary outcome measures included positive resection margin and re-operation rates.

Main Results:

  • Forty-eight patients had single-seed RSL and 58 had multiple-seed RSL.
  • Positive resection margins occurred in 47.9% with single-seed RSL versus 29.3% with multiple-seed RSL (p=0.06).
  • Re-operation rates were 39.6% for single-seed RSL and 20.7% for multiple-seed RSL (p=0.05).

Conclusions:

  • Multiple-seed RSL effectively brackets larger eDCIS areas, potentially reducing positive resection margins.
  • This technique may improve BCS outcomes for patients with extensive disease.