Timing of radiofrequency identification tag placement: can early placement save time and patient experience?

Radiofrequency identification tag localization (TL) is a method of localizing nonpalpable breast cancers and high-risk lesions that can be performed prior to the day of surgery (DOS). We evaluated if placement of TL prior to DOS would affect patients' length of stay (LOS) and improve surgical on-time starts.

A retrospective review of excisional biopsies and lumpectomies with TL was performed. Associations between timing of TL (DOS vs. prior), time in radiology, surgical case delay, LOS on DOS, and total LOS were assessed.

439 patients underwent TL for nonpalpable breast cancer or high-risk lesions between July 2018 and July 2021 at our institutions. 158 TL procedures were performed on the DOS and 281 TL procedures were performed a median of 3 days prior to the DOS (range 1-28). All intended targets were removed. The median total LOS (time in radiology and surgery) was 336 min and 434 min for the early placement group and DOS group, respectively (p < 0.001). The median length of time in radiology was 47 min for the early placement group and 54 min for the DOS group (p < 0.001). Cases were significantly more likely to be delayed (p = 0.002) and could not be first-start cases if TL was performed on DOS. Vasovagal events during TL and narcotic use in the post-operative setting were rare across both groups.

TL prior to DOS was associated with a decrease in total LOS (p < 0.001) and case delay (p = 0.002), as well as an increase in first-start cases. These findings suggest the potential superiority of TL prior to DOS.