Ultrasound-Guided Versus Wire-Guided Breast-Conserving Surgery for Non-palpable Breast Lesions: A Retrospective...

Background Breast-conserving surgery (BCS) is standard for early breast cancer, yet achieving clear surgical margins remains challenging. Ultrasound (US)-guided BCS has emerged as a potential alternative to wire-guided surgery, but its efficacy compared to traditional methods requires evaluation. Methods A retrospective review of patients undergoing BCS from April 2022 to April 2023 at the Portuguese Institute of Oncology of Porto (IPO-Porto) was conducted. Preoperative assessment by the surgeon determined the choice between ultrasound-guided and wire-guided surgery for non-palpable lesions. Results Out of 155 patients, 81 (52.3%) underwent US-guided BCS, while 74 (47.7%) underwent wire-guided BCS. Both groups had similar tumor characteristics and achieved rates of negative surgical margins (69 (92%) versus 53 (93%)). There was no significant difference in intraoperative re-excision rates between the two groups (24 (32%) versus 19 (33.3%); p=8.71). Additionally, the rate of repeat BCS/mastectomy after initial surgery was comparable (6 (8%) versus 4 (7%); p=1.000). Conclusions Ultrasound-guided BCS demonstrates comparable efficacy to wire-guided BCS for non-palpable breast lesions. Both techniques provide similar surgical outcomes, with the potential additional benefits of ultrasound-guided BCS for the patient and in the management of healthcare resources.