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Rapid Implementation of Intraoperative Ultrasonography to Reduce Wire Localization in The Permanente Medical Group
Sharon Chang1, Magdalene Brooke2,3, Elizabeth Cureton3
1Department of Surgery, Fremont Medical Center, CA.
The Permanente Journal
|July 18, 2019
Summary
Hydrogel clips can replace preoperative wire localization for nonpalpable breast lesions, reducing the need for wire localization procedures. This method maintains similar margin positivity rates, offering a cost-effective alternative.
Area of Science:
- Breast surgery
- Radiology
- Oncology
Background:
- Preoperative wire localization (WL) is standard for nonpalpable breast lesions but has drawbacks.
- These include scheduling issues, cost, and patient discomfort.
Purpose of the Study:
- To investigate hydrogel clips as an alternative to WL.
- To reduce WL use in breast cancer surgery.
Main Methods:
- Retrospective review of 143 patients with nonpalpable, ultrasound-visible breast lesions.
- Hydrogel clips were placed during core-needle biopsy.
- Lumpectomies were guided by intraoperative ultrasonography.
Main Results:
- 71.3% of patients did not require WL.
- Lesion sizes and positive margin rates were similar between WL and non-WL groups.
- 67% of patients receiving neoadjuvant chemotherapy avoided WL.
Conclusions:
- A protocol using intraoperative ultrasonography to visualize hydrogel clips decreased WL procedures.
- This technique showed no significant difference in margin positivity compared to WL.
- Hydrogel clips offer a cost-effective alternative to WL for select patients.
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