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Ferreira HHJ, de Souza CD, Pozzo L, Ribeiro MS, Rostelato MECM. Radioactive Seed Localization for Nonpalpable Breast Lesions: Systematic Review and Meta-Analysis. Diagnostics (Basel) 2024; 14:441. [PMID: 38396480 PMCID: PMC10887864 DOI: 10.3390/diagnostics14040441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/22/2023] [Accepted: 12/30/2023] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND This study is a systematic review with meta-analysis comparing radioactive seed localization (RSL) versus radio-guided occult lesion localization (ROLL) and wire-guided localization (WGL) for patients with impalpable breast cancer undergoing breast-conserving surgery and evaluating efficacy, safety, and logistical outcomes. The protocol is registered in PROSPERO with the number CRD42022299726. METHODS A search was conducted in the Embase, Lilacs, Pubmed, Scielo, Web of Science, and clinicaltrials.gov databases, in addition to a manual search in the reference list of relevant articles, for randomized clinical trials and cohort studies. Studies selected were submitted to their own data extraction forms and risk of bias analysis according to the ROB 2 and ROBINS 1 tools. A meta-analysis was performed, considering the random effect model, calculating the relative risk or the mean difference for dichotomous or continuous data, respectively. The quality of the evidence generated was analyzed by outcome according to the GRADE tool. Overall, 46 articles met the inclusion criteria and were included in this systematic review; of these, 4 studies compared RSL and ROLL with a population of 1550 women, and 43 compared RSL and WGL with a population of 19,820 women. RESULTS The results showed that RSL is a superior method to WGL in terms of surgical efficiency in the impalpable breast lesions' intraoperative localization, and it is at least equivalent to ROLL. Regarding security, RSL obtained results equivalent to the already established technique, the WGL. In addition to presenting promising results, RSL has been proven to be superior to WGL and ROLL technologies.
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Affiliation(s)
| | - Carla Daruich de Souza
- Nuclear and Energy Research Institute (IPEN/CNEN—SP), University of São Paulo (USP), Av. Professor Lineu Prestes 2242, São Paulo 05508-000, SP, Brazil; (H.H.J.F.); (L.P.); (M.S.R.); (M.E.C.M.R.)
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Elzohery YH, Gomaa MM, Mohamed G, Fadlalla WM, Taha SN, Ibraheem MH. Comparison of wire-guided localization (WGL) and radio-guided occult lesion localization (ROLL) in localization of non-palpable breast lesions. World J Surg Oncol 2023; 21:266. [PMID: 37626332 PMCID: PMC10463290 DOI: 10.1186/s12957-023-03152-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND The number of patients with non-palpable breast lesions has increased gradually. This is because of the technological development in imaging techniques and the screening programs that lead to early detection of breast lesions. The number of patients with non-palpable breast lesions has increased gradually. This is because of the technological development in imaging techniques and the screening programs that lead to early detection of breast lesions. The aim of marking the non-palpable breast lesions is to achieve accurate lesion localization, to obtain the better cosmetic result with less tissue loss and to provide negative surgical margin. AIM OF THE STUDY In the current study, we aimed to compare the wire-guided localization (WGL) technique with the radio-guided occult lesion localization (ROLL) technique to assess their accuracy and efficacy in non-palpable breast lesions localization. METHODS This is a retrospective study conducted at Baheya center for Early Detection and Treatment of Breast Cancer from January 2018 and June2022,where 670 patients with non-palpable breast lesions underwent an excision were enrolled randomly in ROLL group (n = 320) and WGL (n = 350). RESULTS Both the localization time and the time of operation were significantly decreased with the ROLL in comparison to WGL(P < 0.001). Complete lesion excision with clear margins were reported in 119/135(88.2%) of ROLL group and in 130/159 (81.8%) of WGL group and the difference was significant (P < 0.001). Reoperations (re-lumpectomy or mastectomy) were done as a second procedure on 16(11.8%) of the ROLL patients compared with 29(18.2%) in the WGL patients(P < 0.001). CONCLUSION This study shows that ROLL is as effective as WGL for non-palpable breast lesions excision. Also, ROLL improve the outcomes by decreasing the duration of surgery, localization time, achieving a higher percentage of clear margin in spite of lower specimen size and scar length.
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Affiliation(s)
- Yasmine Hany Elzohery
- Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
- Baheya Center for Early Detection and Treatment of Breast Cancer, Giza, Egypt.
| | - Mohammed Mohammed Gomaa
- Baheya Center for Early Detection and Treatment of Breast Cancer, Giza, Egypt
- Department of Diagnostic and Interventional Radiology, National Cancer Institute, Cairo University, Giza, Egypt
| | - Ghada Mohamed
- Department of Pathology, National Cancer Institute, Cairo University, Giza, Egypt
| | - Waleed Mohamed Fadlalla
- Baheya Center for Early Detection and Treatment of Breast Cancer, Giza, Egypt
- Department of Surgical Oncology, National Cancer Institute, Cairo University, Giza, Egypt
| | - Sherif Nasser Taha
- Baheya Center for Early Detection and Treatment of Breast Cancer, Giza, Egypt
- Department of Surgical Oncology, National Cancer Institute, Cairo University, Giza, Egypt
| | - Maher H Ibraheem
- Baheya Center for Early Detection and Treatment of Breast Cancer, Giza, Egypt
- Department of Surgical Oncology, National Cancer Institute, Cairo University, Giza, Egypt
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3
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elzohery YHAEM, gomaa MM, abdelsalam GM, fadlalla WM, taha SN, ibraheem MH. Comparison of wire-guided localization (WGL) and radio-guided occult lesion localization(ROLL) in localization of non-palpable breast lesions.. [DOI: 10.21203/rs.3.rs-3153699/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Abstract
Background:
The number of patients with non-palpable breast lesions has increased gradually. This is because of the technological development in imaging techniques and the screening programs that lead to early detection of breast lesions.
The aim of marking the non-palpable breast lesions is to achieve accurate lesion localization, to obtain the better cosmetic result with less tissue loss and to provide negative surgical margin.
Aim:the aim of the study is to compare the wire-guided localization (WGL) technique with the radioguided occult lesion localization (ROLL) technique to assess their accuracy and efficacy in non-palpable breast lesions localization.
Methods:From January 2018 and June2022 a total of 670 patients underwent an excision for non-palpable lesions were enrolled randomly in ROLL group (n = 320 ) and WGL (n =350 ) at Baheya center for Early Detection and Treatment of Breast Cancer.
Results: There were no differences between the two groups in terms of age, localization technique.Both the localization time and the time of operation were decreased with the ROLL. Complete lesion excision with clear margins were reported in (88.2%) of ROLL patients and in (81.8%) of WGL patients. Reoperations were done as a second operation on16( 11.8%)of ROLL patients and on 29( 18.2%) of WGL patients.
Conclusion:This study shows that ROLL is as effective as WGL for non-palpable breast lesions excision. Also, ROLL improve the outcomes by decreasing the duration of surgery, localization time,achieving a higher percentage of clear margin in spite of lower specimen size and scar length.
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Catalano O, Fusco R, De Muzio F, Simonetti I, Palumbo P, Bruno F, Borgheresi A, Agostini A, Gabelloni M, Varelli C, Barile A, Giovagnoni A, Gandolfo N, Miele V, Granata V. Recent Advances in Ultrasound Breast Imaging: From Industry to Clinical Practice. Diagnostics (Basel) 2023; 13:diagnostics13050980. [PMID: 36900124 PMCID: PMC10000574 DOI: 10.3390/diagnostics13050980] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
Breast ultrasound (US) has undergone dramatic technological improvement through recent decades, moving from a low spatial resolution, grayscale-limited technique to a highly performing, multiparametric modality. In this review, we first focus on the spectrum of technical tools that have become commercially available, including new microvasculature imaging modalities, high-frequency transducers, extended field-of-view scanning, elastography, contrast-enhanced US, MicroPure, 3D US, automated US, S-Detect, nomograms, images fusion, and virtual navigation. In the subsequent section, we discuss the broadened current application of US in breast clinical scenarios, distinguishing among primary US, complementary US, and second-look US. Finally, we mention the still ongoing limitations and the challenging aspects of breast US.
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Affiliation(s)
- Orlando Catalano
- Department of Radiology, Istituto Diagnostico Varelli, 80126 Naples, Italy
| | - Roberta Fusco
- Medical Oncology Division, Igea SpA, 80013 Naples, Italy
- Correspondence:
| | - Federica De Muzio
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy
| | - Igino Simonetti
- Division of Radiology, “Istituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS di Napoli”, 80131 Naples, Italy
| | - Pierpaolo Palumbo
- Department of Diagnostic Imaging, Area of Cardiovascular and Interventional Imaging, Abruzzo Health Unit 1, 67100 L’Aquila, Italy
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
| | - Federico Bruno
- Department of Diagnostic Imaging, Area of Cardiovascular and Interventional Imaging, Abruzzo Health Unit 1, 67100 L’Aquila, Italy
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
| | - Alessandra Borgheresi
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, 60126 Ancona, Italy
- Department of Radiology, University Hospital “Azienda Ospedaliera Universitaria delle Marche”, 60126 Ancona, Italy
| | - Andrea Agostini
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, 60126 Ancona, Italy
- Department of Radiology, University Hospital “Azienda Ospedaliera Universitaria delle Marche”, 60126 Ancona, Italy
| | - Michela Gabelloni
- Department of Translational Research, Diagnostic and Interventional Radiology, University of Pisa, 56126 Pisa, Italy
| | - Carlo Varelli
- Department of Radiology, Istituto Diagnostico Varelli, 80126 Naples, Italy
| | - Antonio Barile
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, 67100 L’Aquila, Italy
| | - Andrea Giovagnoni
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, 60126 Ancona, Italy
- Department of Radiology, University Hospital “Azienda Ospedaliera Universitaria delle Marche”, 60126 Ancona, Italy
| | - Nicoletta Gandolfo
- Diagnostic Imaging Department, Villa Scassi Hospital-ASL 3, Corso Scassi 1, 16149 Genoa, Italy
| | - Vittorio Miele
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
- Department of Emergency Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Vincenza Granata
- Division of Radiology, “Istituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS di Napoli”, 80131 Naples, Italy
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Diagnostic accuracy of resection margin in specimen radiography: digital breast tomosynthesis versus full-field digital mammography. Radiol Med 2021; 126:768-773. [PMID: 33625658 DOI: 10.1007/s11547-021-01337-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 02/03/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We investigated the accuracy of digital breast tomosynthesis compared to full-field digital mammography for evaluating tumor-free resection margins in the intraoperative specimen during breast-conserving surgery, reducing re-excision rates. MATERIALS AND METHODS In total, 170 patients, with proven breast cancer and eligible for breast-conserving surgery, were enrolled. Intraoperative specimens underwent digital mammography and digital breast tomosynthesis. Two breast radiologists, with ten years of experience in breast imaging, in batch mode, evaluated tumor-free resection margins and the distance between the margins and lesion. Histopathological findings were considered the standard of reference. RESULTS We used the correlation analysis to evaluate the agreement between measures of tumor-free resection margins obtained with digital mammography and the true value (histopathological findings), and between digital breast tomosynthesis and histopathological findings. The size evaluation determined by digital breast tomosynthesis was more accurately correlated with that found by pathology; the calculated Pearson's correlation coefficient of digital breast tomosynthesis and digital mammography to the pathologically determined tumor-free resection margins were 0.92 and 0.79 in CC view and 0.92 and 0.72 in LL view, respectively. Compared with the pathologically determined tumor-free resection margins, the size determined by both imaging modalities was, on average, overestimated. Bland-Altman analysis showed an excellent inter readers agreement. CONCLUSIONS Digital breast tomosynthesis is more accurate in assessment of margin status than digital mammography; it could be a more accurate technique than full-field digital mammography for the intraoperative delineating of tumor resection margins.
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Franceschini G, Mason EJ, Grippo C, D’Archi S, D’Angelo A, Scardina L, Sanchez AM, Conti M, Trombadori C, Terribile DA, Di Leone A, Carnassale B, Belli P, Manfredi R, Masetti R. Image-Guided Localization Techniques for Surgical Excision of Non-Palpable Breast Lesions: An Overview of Current Literature and Our Experience with Preoperative Skin Tattoo. J Pers Med 2021; 11:jpm11020099. [PMID: 33557072 PMCID: PMC7913802 DOI: 10.3390/jpm11020099] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/13/2021] [Accepted: 02/01/2021] [Indexed: 01/14/2023] Open
Abstract
Breast conserving surgery has become the standard of care and is more commonly performed than mastectomy for early stage breast cancer, with recent studies showing equivalent survival and lower morbidity. Accurate preoperative lesion localization is mandatory to obtain adequate oncological and cosmetic results. Image guidance assures the precision requested for this purpose. This review provides a summary of all techniques currently available, ranging from the classic wire positioning to the newer magnetic seed localization. We describe the procedures and equipment necessary for each method, outlining the advantages and disadvantages, with a focus on the cost-effective preoperative skin tattoo technique performed at our centre. Breast surgeons and radiologists have to consider ongoing technological developments in order to assess the best localization method for each individual patient and clinical setting.
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Affiliation(s)
- Gianluca Franceschini
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (G.F.); (S.D.); (L.S.); (A.M.S.); (D.A.T.); (A.D.L.); (B.C.); (R.M.)
- Dipartimento di Scienze Mediche e Chirurgiche, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Elena Jane Mason
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (G.F.); (S.D.); (L.S.); (A.M.S.); (D.A.T.); (A.D.L.); (B.C.); (R.M.)
- Correspondence: ; Tel.: +39-33-5700-4572
| | - Cristina Grippo
- Dipartimento di Diagnostica per Immagini, Radiologia Terapeutica ed Interventistica, Azienda Ospedaliera Santa Maria Terni, 05100 Terni, Italy;
| | - Sabatino D’Archi
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (G.F.); (S.D.); (L.S.); (A.M.S.); (D.A.T.); (A.D.L.); (B.C.); (R.M.)
| | - Anna D’Angelo
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (A.D.); (M.C.); (C.T.); (P.B.); (R.M.)
| | - Lorenzo Scardina
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (G.F.); (S.D.); (L.S.); (A.M.S.); (D.A.T.); (A.D.L.); (B.C.); (R.M.)
| | - Alejandro Martin Sanchez
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (G.F.); (S.D.); (L.S.); (A.M.S.); (D.A.T.); (A.D.L.); (B.C.); (R.M.)
| | - Marco Conti
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (A.D.); (M.C.); (C.T.); (P.B.); (R.M.)
| | - Charlotte Trombadori
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (A.D.); (M.C.); (C.T.); (P.B.); (R.M.)
| | - Daniela Andreina Terribile
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (G.F.); (S.D.); (L.S.); (A.M.S.); (D.A.T.); (A.D.L.); (B.C.); (R.M.)
- Dipartimento di Scienze Mediche e Chirurgiche, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Alba Di Leone
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (G.F.); (S.D.); (L.S.); (A.M.S.); (D.A.T.); (A.D.L.); (B.C.); (R.M.)
| | - Beatrice Carnassale
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (G.F.); (S.D.); (L.S.); (A.M.S.); (D.A.T.); (A.D.L.); (B.C.); (R.M.)
| | - Paolo Belli
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (A.D.); (M.C.); (C.T.); (P.B.); (R.M.)
| | - Riccardo Manfredi
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (A.D.); (M.C.); (C.T.); (P.B.); (R.M.)
| | - Riccardo Masetti
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (G.F.); (S.D.); (L.S.); (A.M.S.); (D.A.T.); (A.D.L.); (B.C.); (R.M.)
- Dipartimento di Scienze Mediche e Chirurgiche, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Moreira IC, Ventura SR, Ramos I, Fougo JL, Rodrigues PP. Preoperative localisation techniques in breast conservative surgery: A systematic review and meta-analysis. Surg Oncol 2020; 35:351-373. [DOI: 10.1016/j.suronc.2020.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 08/18/2020] [Accepted: 09/06/2020] [Indexed: 01/20/2023]
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Madeley C, Kessell M, Madeley C, Taylor D. A comparison of stereotactic and tomosynthesis-guided localisation of impalpable breast lesions. J Med Radiat Sci 2019; 66:170-176. [PMID: 31347295 PMCID: PMC6745377 DOI: 10.1002/jmrs.348] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 05/23/2019] [Accepted: 06/17/2019] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Impalpable breast cancers require precise pre-operative lesion localisation to minimise re-excision rates. Conventional techniques include hookwire insertion using stereotactic guidance. Newer techniques include the use of tomosynthesis guidance and the use of iodine-125 seeds. This study compares the accuracy of lesion localisation with hookwire or seed insertion using prone stereotactic or upright tomosynthesis guidance. METHODS This registered quality improvement activity did not require formal ethics approval. The post-localisation images for 116 lesions were reviewed. The distance from the lesion or breast biopsy marker to the hookwire or seed was measured on post-insertion mammograms. The relative placement accuracy of hookwire or seed using prone stereotactic or upright tomosynthesis guidance was compared. A lesion to seed or wire distance > 10 mm was considered technically unsatisfactory. RESULTS 94.8% of the seeds and wires inserted via prone stereotactic guidance were accurately placed, compared with 89.6% of those inserted via upright tomosynthesis. There were twice as many technically unsatisfactory insertions under upright tomosynthesis guidance. The majority of the unsatisfactory insertions using upright tomosynthesis occurred when the lesion was at or below the level of the nipple and the insertion was performed craniocaudally. CONCLUSION The degree of accuracy of pre-operative localisation of impalpable breast lesions is significantly higher with the use of prone stereotactic rather than upright tomosynthesis guidance. This was most evident with the placement of I-125 seeds, and in cases where the target lesion was located below the level of the nipple.
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Affiliation(s)
- Carolyn Madeley
- Department of Diagnostic and Interventional RadiologyRoyal Perth HospitalPerthWestern AustraliaAustralia
- Breast Screen Western AustraliaPerthWestern AustraliaAustralia
| | - Meredith Kessell
- Department of Diagnostic and Interventional RadiologyRoyal Perth HospitalPerthWestern AustraliaAustralia
| | | | - Donna Taylor
- Department of Diagnostic and Interventional RadiologyRoyal Perth HospitalPerthWestern AustraliaAustralia
- Medical School, Faculty of Health and Medical SciencesUniversity of Western AustraliaCrawleyWestern AustraliaAustralia
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9
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Neoadjuvant therapy for breast cancer treatment: an expert panel recommendation from the Brazilian Society of Breast Surgeons 2018. Breast Cancer Res Treat 2018; 172:265-272. [DOI: 10.1007/s10549-018-4912-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 08/02/2018] [Indexed: 01/30/2023]
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10
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Peng Y, Luo ZY, Ni J, Cui HD, Lu B, Xiang AZ, Zhou J, Ding JW, Chen WH, Zhao J, Fang JH, Zhao P. Precision biopsy of breast microcalcifications: An improvement in surgical excision. Oncol Lett 2018; 16:1212-1218. [PMID: 30061943 DOI: 10.3892/ol.2018.8787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 02/23/2018] [Indexed: 11/06/2022] Open
Abstract
The aim of the present study was to improve the conventional wire-guided localization biopsy (WGLB) of breast microcalcifications to overcome disadvantages associated with the procedure, including inaccurate localization and large specimen volume. The novel approach described in the present study was termed double wire-guided localization and rotary cutting biopsy (DWGLB). Prior to surgery, the precise localization of the lesions was assessed using two wires under the assistance of mammography X-ray and ultrasound, followed by complete excision of the lesions using a novel rotary cutting tool. The cylindrical specimen was placed on a scaled specimen holder for pathological examination. DWGLB was performed in 108 patients with the classification of as Breast Imaging Reporting and Data System score 4A. Percutaneous localization of the lesions guided by a mammography X-ray and ultrasound were successful in all 108 lesions (100%) with one puncture attempt. The lesions were precisely excised in all of 108 patients, and included 13 malignant lesions (DCIS of breast in 7 cases, DCIS with focal invasive carcinoma in 3 cases and invasive ductal carcinoma in 3 cases). The average distance of the BARD Dualok to the lesion was 4.1 mm; the average weight of specimens was 8.5 g. Compared with WGLB, DWGLB offers several advantages, including more accurate localization of lesions, a more standardized biopsy method and a smaller specimen volume. DWGLB can also provide the precise position of lesions in the specimen for further pathological examination.
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Affiliation(s)
- You Peng
- Department of Oncological Surgery, Hangzhou First People's Hospital, Hangzhou, Zhejiang 310006, P.R. China
| | - Zhong-Yao Luo
- Department of Oncological Surgery, Hangzhou First People's Hospital, Hangzhou, Zhejiang 310006, P.R. China
| | - Jie Ni
- Department of General Surgery, Hangzhou First People's Hospital, Hangzhou, Zhejiang 310006, P.R. China
| | - Hai-Dong Cui
- Department of General Surgery, Hangzhou First People's Hospital, Hangzhou, Zhejiang 310006, P.R. China
| | - Bei Lu
- Department of General Surgery, Hangzhou First People's Hospital, Hangzhou, Zhejiang 310006, P.R. China
| | - Ai-Zhai Xiang
- Department of General Surgery, Hangzhou First People's Hospital, Hangzhou, Zhejiang 310006, P.R. China
| | - Jun Zhou
- Department of General Surgery, Hangzhou First People's Hospital, Hangzhou, Zhejiang 310006, P.R. China
| | - Jin-Wang Ding
- Department of Oncological Surgery, Hangzhou First People's Hospital, Hangzhou, Zhejiang 310006, P.R. China
| | - Wen-Hui Chen
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, Zhejiang 310006, P.R. China
| | - Jing Zhao
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, Zhejiang 310006, P.R. China
| | - Jian-Hua Fang
- Department of Ultrasound, Hangzhou First People's Hospital, Hangzhou, Zhejiang 310006, P.R. China
| | - Pan Zhao
- Department of Pathology, Hangzhou First People's Hospital, Hangzhou, Zhejiang 310006, P.R. China
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11
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Taylor DB, Bourke AG, Hobbs MM, Dixon G, Phillips M, Saunders CM. Breast localization techniques and margin definitions used by Australian and New Zealand surgeons. ANZ J Surg 2016; 86:744-745. [PMID: 27701839 DOI: 10.1111/ans.13632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 03/15/2016] [Accepted: 04/11/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Donna B Taylor
- Department of Diagnostic and Interventional Radiology, Royal Perth Hospital, Perth, Western Australia, Australia.,School of Surgery, University of Western Australia, Perth, Western Australia, Australia
| | - Anita G Bourke
- School of Surgery, University of Western Australia, Perth, Western Australia, Australia.,Breast Clinic, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Max M Hobbs
- Department of Radiology, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Glenys Dixon
- School of Surgery, University of Western Australia, Perth, Western Australia, Australia
| | - Michael Phillips
- Harry Perkins Institute for Medical Research, University of Western Australia, Perth, Western Australia, Australia
| | - Christobel M Saunders
- School of Surgery, University of Western Australia, Perth, Western Australia, Australia
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Delmonico L, Bravo M, Silvestre RT, Ornellas MHF, De Azevedo CM, Alves G. Proteomic profile of saliva and plasma from women with impalpable breast lesions. Oncol Lett 2016; 12:2145-2152. [PMID: 27602154 PMCID: PMC4998569 DOI: 10.3892/ol.2016.4828] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 06/10/2016] [Indexed: 12/22/2022] Open
Abstract
The present study evaluated the proteomic profile of saliva and plasma from women with impalpable breast lesions using nano-liquid chromatography-quadrupole-time-of-flight (nLC-Q-TOF) technology. Plasma and saliva from patients with fibroadenoma (n=10), infiltrating ductal carcinoma (n=10) and healthy control groups (n=8) were assessed by combinations of inter/intra-group analyses, revealing significant quantitative and qualitative differences. The major differentially-expressed proteins in the saliva of patients compared with the controls were α2-macroglobulin and ceruloplasmin, but the proteins that met the minimum fold-change and P-value cut-offs were leukocyte elastase inhibitor and α-enolase, and deleted in malignant brain tumors 1. Concerning plasma, α-2-macroglobulin and ceruplasmin were upregulated, while other proteins such as haptoglobin, hemopexin and vitamin D-binding protein were downregulated compared with the control. The changes in immune, molecular transport and signaling pathways were the most representative in the proteomic profile of the saliva and plasma. This is the first study to describe the proteome of saliva and plasma from the same women with impalpable breast lesions.
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Affiliation(s)
- Lucas Delmonico
- Research Coordination, National Cancer Institute, Rio de Janeiro 20230-130, Brazil
- Graduate Program of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro 20550-170, Brazil
- Circulating Markers Laboratory, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro 20550-170, Brazil
| | - Maryah Bravo
- Research Coordination, National Cancer Institute, Rio de Janeiro 20230-130, Brazil
- Circulating Markers Laboratory, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro 20550-170, Brazil
| | - Rafaele Tavares Silvestre
- Research Coordination, National Cancer Institute, Rio de Janeiro 20230-130, Brazil
- Graduate Program of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro 20550-170, Brazil
- Circulating Markers Laboratory, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro 20550-170, Brazil
| | - Maria Helena Faria Ornellas
- Graduate Program of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro 20550-170, Brazil
- Circulating Markers Laboratory, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro 20550-170, Brazil
| | | | - Gilda Alves
- Research Coordination, National Cancer Institute, Rio de Janeiro 20230-130, Brazil
- Graduate Program of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro 20550-170, Brazil
- Circulating Markers Laboratory, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro 20550-170, Brazil
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Intraoperative 3D Navigation for Single or Multiple 125I-Seed Localization in Breast-Preserving Cancer Surgery. Clin Nucl Med 2016; 41:e216-20. [DOI: 10.1097/rlu.0000000000001081] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Urano M, Shiraki N, Kawai T, Goto T, Endo Y, Yoshimoto N, Toyama T, Shibamoto Y. Digital mammography versus digital breast tomosynthesis for detection of breast cancer in the intraoperative specimen during breast-conserving surgery. Breast Cancer 2015. [PMID: 26198975 DOI: 10.1007/s12282-015-0628-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE To compare the diagnostic ability of specimen radiography using digital mammography (DM) and digital breast tomosynthesis (DBT) for detecting breast cancer and evaluating its extension in the intraoperative specimen. METHODS Sixty-five specimens from 65 women (median 62 years; range 34-86) obtained during breast-conserving surgery were prospectively investigated. Specimens underwent DM (25-40 kVp, 12-322 mA s) and DBT (25-34 kVp, 13-137 mA) in two orthogonal planes, anteroposterior (AP) and latero-lateral (LL). Images were interpreted by a radiologist to detect invasive lesions and their extensive intraductal components (EIC) or ductal carcinomas in situ (DCIS); afterwards, they were compared with histopathological findings. RESULTS In AP views, 96 % of the invasive lesions were detected by both the methods. Of the EICs, 55 and 65 % were detected by DM and DBT, respectively (P = 0.61). Of the DICSs, 31 and 38 % were detected by DM and DBT, respectively (P > 0.99). In LL views, 71 and 13 % of the invasive lesions were detected by DBT and DM, respectively (P < 0.0001). Of the EICs, 42 and 10 % were detected by DBT and DM, respectively (P = 0.0078). Of the 13 DCISs, 42 and 8 % were detected by DBT and DM, respectively (P = 0.32). The whole lesion and contour could be delineated in 45 % by DBT and in 6.2 % by DM (P < 0.0001). CONCLUSIONS DBT could detect breast cancer more accurately than DM in LL views, indicating its potential to more precisely diagnose vertical invasion.
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Affiliation(s)
- Misugi Urano
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
| | - Norio Shiraki
- Department of Radiology, Nagoya City West Medical Center, Nagoya, Japan
| | - Tatsuya Kawai
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Taeko Goto
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Yumi Endo
- Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Nobuyasu Yoshimoto
- Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Tatsuya Toyama
- Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yuta Shibamoto
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
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Assessment of MRI Issues at 3 Tesla for a New Metallic Tissue Marker. Int J Breast Cancer 2015; 2015:823759. [PMID: 26266051 PMCID: PMC4525757 DOI: 10.1155/2015/823759] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Revised: 06/21/2015] [Accepted: 06/24/2015] [Indexed: 12/26/2022] Open
Abstract
Purpose. To assess the MRI issues at 3 Tesla for a metallic tissue marker used to localize removal areas of tissue abnormalities. Materials and Methods. A newly designed, metallic tissue marker (Achieve Marker, CareFusion, Vernon Hills, IL) used to mark biopsy sites, particularly in breasts, was assessed for MRI issues which included standardized tests to determine magnetic field interactions (i.e., translational attraction and torque), MRI-related heating, and artifacts at 3 Tesla. Temperature changes were determined for the marker using a gelled-saline-filled phantom. MRI was performed at a relatively high specific absorption rate (whole body averaged SAR, 2.9-W/kg). MRI artifacts were evaluated using T1-weighted, spin echo and gradient echo pulse sequences. Results. The marker displayed minimal magnetic field interactions (2-degree deflection angle and no torque). MRI-related heating was only 0.1°C above background heating (i.e., the heating without the tissue marker present). Artifacts seen as localized signal loss were relatively small in relation to the size and shape of the marker. Conclusions. Based on the findings, the new metallic tissue marker is acceptable or “MR Conditional” (using current labeling terminology) for a patient undergoing an MRI procedure at 3 Tesla or less.
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Localization of nonpalpable breast lesions with sonographically visible clip: optimizing tailored resection and clear margins. Am J Surg 2015; 209:950-8. [DOI: 10.1016/j.amjsurg.2014.07.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 07/03/2014] [Accepted: 07/16/2014] [Indexed: 12/14/2022]
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Pouw B, der Veen LJDWV, Hellingman D, Brouwer OR, Peeters MJTV, Stokkel MP, Olmos RAV. Feasibility of preoperative (125)I seed-guided tumoural tracer injection using freehand SPECT for sentinel lymph node mapping in non-palpable breast cancer. EJNMMI Res 2014; 4:19. [PMID: 24949282 PMCID: PMC4052880 DOI: 10.1186/s13550-014-0019-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 03/27/2014] [Indexed: 11/25/2022] Open
Abstract
Background This study was designed to explore the feasibility of replacing the conventional peri-/intratumoural ultrasound (US)-guided technetium-99m albumin nanocolloid (99mTc-nanocolloid) administration by an injection of the same tracer guided by a freehand single-photon emission computed tomography (SPECT) device in patients with non-palpable breast cancer with an iodine-125 (125I) seed as tumour marker, who are scheduled for a sentinel lymph node biopsy (SLNB). This approach aimed to decrease the workload of the radiology department, avoiding a second US-guided procedure. Methods In ten patients, the implanted 125I seed was primarily localised using freehand SPECT and subsequently verified by conventional US in order to inject the 99mTc-nanocolloid. The following 34 patients were injected using only freehand SPECT localisation. In these patients, additional SPECT/CT was acquired to measure the distance between the 99mTc-nanocolloid injection depot and the 125I seed. In retrospect, a group of 21 patients with US-guided 99mTc-nanocolloid administrations was included as a control group. Results The depth difference measured by US and freehand SPECT in ten patients was 1.6 ± 1.6 mm. In the following 36 125I seeds (34 patients), the average difference between the 125I seed and the centre of the 99mTc-nanocolloid injection depot was 10.9 ± 6.8 mm. In the retrospective study, the average distance between the 125I seed and the centre of the 99mTc-nanocolloid injection depot as measured in SPECT/CT was 9.7 ± 6.5 mm and was not significantly different compared to the freehand SPECT-guided group (two-sample Student's t test, p = 0.52). Conclusion We conclude that using freehand SPECT for 99mTc-nanocolloid administration in patients with non-palpable breast cancer with previously implanted 125I seed is feasible. This technique may improve daily clinical logistics, reducing the workload of the radiology department.
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Affiliation(s)
- Bas Pouw
- MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede 7500 AE, The Netherlands ; Department of Nuclear Medicine, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam 1066 CX, The Netherlands
| | - Linda J de Wit-van der Veen
- Department of Nuclear Medicine, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam 1066 CX, The Netherlands
| | - Daan Hellingman
- MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede 7500 AE, The Netherlands ; Department of Nuclear Medicine, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam 1066 CX, The Netherlands
| | - Oscar R Brouwer
- Department of Nuclear Medicine, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam 1066 CX, The Netherlands
| | - Marie-Jeanne Tfd Vrancken Peeters
- Department of Surgical Oncology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam 1066 CX, The Netherlands
| | - Marcel Pm Stokkel
- Department of Nuclear Medicine, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam 1066 CX, The Netherlands
| | - Renato A Valdés Olmos
- Department of Nuclear Medicine, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam 1066 CX, The Netherlands
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