Iodine-125 seed versus hook-wire guided breast conserving surgery: do post operative complication rates differ?

Area of Science:

• Oncology
• Surgical Oncology
• Radiology

Background:

• Radio-guided occult lesion localization using iodine 125 seeds (ROLLIS) is an established technique for localizing impalpable breast cancers for breast-conserving surgery (BCS).
• Prior research suggests ROLLIS may offer improved efficiency and patient outcomes compared to traditional hook-wire localization (HWL).

Purpose of the Study:

• To compare the post-operative complication rates and safety profiles of ROLLIS versus hook-wire guided surgery for breast cancer localization.

Main Methods:

• A randomized clinical trial (ROLLIS trial) involving 690 women with non-palpable breast cancer undergoing BCS.
• A retrospective medical record review of 170 women (30% of participants) from three tertiary hospitals.
• Post-operative complications were classified using the Common Terminology Criteria for Adverse Events (CTCAE) grades I-V.

Main Results:

• A total of 170 surgeries were analyzed: 82 by ROLLIS and 88 by hook-wire.
• The overall complication rate was 19.5% for ROLLIS (15.9% grade II, 3.66% grade III) and 22.7% for HWL (20.5% grade II, 2.27% grade III).
• No statistically significant difference in complication grades was observed between the two groups; no grade IV or V complications occurred.

Conclusions:

• ROLLIS is a safe and effective localization technique for breast cancer surgery, comparable to hook-wire localization in terms of complication rates.
• The study supports the adoption of ROLLIS as a viable alternative localization method due to its demonstrated efficacy.