Abstract
Background: The use of preoperative wire localization (PWL) for excision of nonpalpable breast lesions has several disadvantages. The purpose of this study was to evaluate the use of intraoperative ultrasound localization (IUL) and to compare it with PWL.
Methods: Twenty-nine patients (22 with cancer) underwent IUL in a solo surgical practice over a 21-month period. They were compared to 22 patients with cancer in the same practice who underwent PWL in a similar time period. Parameters analyzed included accuracy of lesion removal, margin involvement, extent of disease-free margin, and the amount of tissue removed.
Results: The targeted lesions were accurately removed 100% of the time, and disease-free margins were obtained at the first operation in 82% of patients in both groups. An equivalent amount of disease-free margin (IUL, 6.6 mm; PWL, 6.7 mm) was obtained with IUL while removing a smaller (IUL, 62.6 cm3; PWL, 81.1 cm3) mean volume of tissue.
Conclusions: IUL is an accurate method of localizing most nonpalpable mass lesions identified on mammography. Equivalent margin status can be achieved while removing no more tissue than with PWL. The trauma of wire localization in an awake patient is avoided.
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REFERENCES
Kelly P, Winslow EH. Needle wire localization for nonpalpable breast lesions: sensations, anxiety levels, and informational needs. Oncol Nurs Forum 1996;23:639–645.
Dowlatshahi K, Jokich PM, Schmidt R, Bibbo M, Dawson J. Diagnosis of occult breast lesions using stereotaxic needle cytology. Arch Surg 1987;122:1343–1346.
Parker SH, Jobe WE, Dennis MA, et al. Ultrasound-guided automated large core breast biopsy. Radiology 1992;187:507–511.
Norton LW, Zeligman BE, Pearlman NW. Accuracy and cost of needle localization breast biopsy. Arch Surg 1988;123:947–950.
Grannan KJ, Lamping K. Impact of method of anesthesia on the accuracy of needle-localized breast biopsies. Am J Surg 1993;165:218–220.
della Rovere GQ, Benson JR, Morgan M, Warren R, Patel A. Localization of impalpable breast lesions—a surgical approach. Euro J Surg Oncol 1996;22:478–482.
Papa MZ, Klein E, Davidson B, et al. The effect of anesthesia type on needle localization breast biopsy: another point of view. Am J Surg 1996;171:242–243.
Chadwick DR, Shorthouse AJ. Wire-directed localization biopsy of the breast: an audit of results and analysis of factors influencing therapeutic value in treatment of breast cancer. Euro J Surg Oncol 1997;23:128–133.
Cleverley JR, Jackson AR, Bateman AC. Pre-operative localization of breast microcalcification using high-frequency ultrasound. Clin Radiol 1997;52:924–926.
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Snider, H.C., Morrison, D.G. Intraoperative Ultrasound Localization of Nonpalpable Breast Lesions. Ann Surg Oncol 6, 308–314 (1999). https://doi.org/10.1007/s10434-999-0308-9
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DOI: https://doi.org/10.1007/s10434-999-0308-9