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Low-Cost Radio-Opaque Tumor Marking Techniques for Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy: a

S Bharath1, Sanjay Kumar Yadav1, Dhananjaya Sharma1

  • 1Department of Surgery, NSCB Medical College, Jabalpur, India.

Indian Journal of Surgical Oncology
|March 21, 2024
PubMed
Summary

Low-cost radio-opaque tumor markers, including LIGA clips and K-wire, offer effective breast cancer localization for breast-conserving surgery. These methods are feasible and highly visible, proving valuable, especially in lower-middle-income countries.

Keywords:
Breast cancerBreast conservation surgeryNeoadjuvant chemotherapyRadio-opaque tumor markersTumor mapping

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Medical Devices

Background:

  • Standard breast-conserving surgery (BCS) localization methods post-neoadjuvant chemotherapy (NACT) are often costly and inaccessible in lower-middle-income countries (LMICs).
  • Effective tumor localization is crucial for successful BCS, ensuring clear margins and optimal patient outcomes.

Purpose of the Study:

  • To evaluate the efficacy of low-cost, radio-opaque tumor markers for breast cancer localization in patients undergoing BCS after NACT.
  • To assess the feasibility and effectiveness of alternative, affordable marking techniques suitable for resource-limited settings.

Main Methods:

  • A systematic literature search was conducted following PRISMA guidelines up to November 30, 2022, focusing on non-commercial radio-opaque markers for BCS post-NACT.
  • Seven studies were included, analyzing data on LIGA clips, cut K-wire pieces, and cut 25-G needle pieces as tumor markers.
  • The primary outcome was the rate of unsatisfactory margins (positive/close) on final histology; internal validity was assessed using OCEBM levels.

Main Results:

  • Low-cost markers (LIGA clips, K-wire, 25-G needle) demonstrated feasibility in all included studies.
  • Tumor visibility before surgery was 100%, and retrieval rates were also 100%.
  • The incidence of unsatisfactory margins ranged from 0% to 11% across the studies.

Conclusions:

  • Low-cost radio-opaque tumor markers, such as LIGA clips, cut K-wire, and cut 25-G needle pieces, are effective for tumor localization in BCS.
  • These affordable methods are particularly suitable for LMICs, addressing accessibility issues with standard techniques.
  • The high visibility and retrieval rates confirm their practical utility in clinical settings.