Comparison of Radiofrequency Identification, Radioactive Seed, and Wire Localization Techniques for Nonpalpable...

Several localization techniques have been described for accurate resection of nonpalpable breast cancers during breast conserving surgery. This study compares surgical outcomes of 3 different techniques.

A retrospective chart review was performed between 2015 and 2022 of patients undergoing lumpectomy with radiofrequency identification (RFID) tags, radioactive seed (RSL), or wire localization (WL). Demographic and tumor characteristics were evaluated. Primary outcomes were pathological margin status and reoperation rates. Secondary outcomes were ductal carcinoma-in-situ (DCIS) close margin (less than 2 mm), lumpectomy specimen volume (LSV), device to specimen edge distance (DSED) measured radiographically, procedure time, and intraoperative selective shave margins (ISSM) use. Univariate and multivariate logistic and linear regression analyses were conducted where appropriate.

A total of 777 patients were identified: 239 RFID, 347 RSL, and 191 WL. Demographic and tumor characteristics were similar between groups. There were no statistically significant differences in positive margins and reoperation rates. RFID had the largest LSV and DSED. ISSM rates were half as frequent for RSL than RFID and WL. The procedure time was longer for WL. DCIS close margin was more common with RFID. On multivariate analysis, RFID was independently associated with increased DSED, decreased procedure time, and increased rate of DCIS close margin relative to WL. RSL was also independently associated with lower rates of ISSM, decreased LSV, and decreased procedure time compared with WL (all p < 0.001).

Comparison of localization techniques revealed no differences in primary outcomes. However, there were significant differences in secondary outcomes that can influence patient and surgeon satisfaction.