Comparison of the Localizer (RFID) and Wire Localization (WL) Techniques in the Localization of Non-palpable Breast...

Introduction Since the introduction of breast cancer screening programs through mammography, the number of breast tumors requiring surgery has increased, particularly non-palpable tumors. Surgery on non-palpable breast tumors necessitates the use of image-guided preoperative localization methods. These are divided into wire methods, such as Wire Localization (WL), and wireless methods such as the Localizer (radiofrequency identification; RFID). Each has its own advantages and disadvantages. The objective of this study was to compare margin status, re-excision rates, operative time, and device migration between Localizer (RFID) and WL in the surgical management of non-palpable breast tumors. Material and methods A cross-sectional retrospective cohort study was conducted on patients who underwent partial mastectomy for non-palpable breast tumors between January 1, 2020, and December 31, 2023, at Simone Veil Hospital, Eaubonne, France. Patients were divided into two groups according to the tumor localization technique used. Univariate analyses were performed to assess the relationships between the two groups regarding patient characteristics, surgical parameters, and surgical outcomes. Results Out of 129 patients, 66/129 (51.1%) underwent tumor localization with the Localizer, while 63/129 (48.8%) underwent tumor localization with WL. The rate of positive margins (RFID: 12/66 (18.2%) versus WL: 18/63 (28.6%), p = 0.23), re-excision for positive margins (RFID: 9/66 (13.6%) versus WL: 15/63 (23.8%), p = 0.21), and operative complications (RFID: 14/66 (21.2%) versus WL: 9/63 (14.3%), p = 0.43) were similar between the two groups. The period between device insertion and surgery was 9 (± 15.8) days for the Localizer and 1 (± 0.5) days for WL (p < 0.01). The operative time was 81.1 (± 35.9) minutes when WL was used, compared to 67.9 (± 27.8) minutes for the Localizer (p = 0.02). The migration rate of the device was comparable between the two methods (RFID: 4/66 (6.1%) versus WL: 3/63 (4.8%), p = 1). Age (RFID: 59.9 (± 14.1) versus WL: 62.9 (± 14.3), p = 0.024) and device migration (OR = 1.7, p = 0.04) were associated with margin status. Conclusion In this retrospective cohort, no statistically significant differences were observed between the Localizer and WL in terms of surgical margins or complications. The Localizer, however, provided logistical advantages, including earlier placement and shorter operative time. Importantly, older age and device migration were significantly associated with positive margins, offering clinically relevant insight for surgical planning. Larger prospective or randomized trials are required to confirm whether meaningful differences exist between these localization methods, after which patient-centered outcomes, such as comfort and acceptability, should be further explored.