A comparison of two non-radioactive alternatives to wire for the localization of non-palpable breast cancers

Abstract

Purpose

Multiple wire-free technologies for localization of non-palpable breast cancers have emerged as satisfactory alternatives to wire. However, no study has compared two non-radioactive wire-free approaches to one another. The purpose of this study was to compare outcomes among LOCalizer™ radiofrequency identification (RFID), SAVI Scout® (SAVI), and wire localization (WL).

Methods

This was a retrospective, cross-sectional cohort study of patients undergoing lumpectomy for non-palpable breast cancer at a single institution between August 2017 and February 2019. Patients were divided into three cohorts based on localization technique: RFID, SAVI or WL. Operative times and average tumor volumes were compared using one-way analysis of variance. Positive margin and re-excision rates were compared with Fisher’s exact test.

Results

Among 104 patients who underwent lumpectomy for non-palpable breast cancer, 33 patients (31.7%) had RFID, 21 (20.2%) had SAVI, and 50 (48.0%) had WL. Operative times were 79 min for RFID, 81 min for SAVI, and 78 min for WL (p = 0.91). Volume of tissue resected was 36.3 cm3, 31.7 cm3, and 35.3 cm3 for RFID, SAVI, and WL, respectively (p = 0.84). Positive margin rates (RFID 3.0% vs SAVI 9.5% vs WL 8.0%, p = 0.67) and re-excision rates (RFID 6.1% vs SAVI 9.5% vs WL 10.0%, p = 0.82) were similar across groups.

Conclusions

Wire-free localization technologies have been compared to WL demonstrating similar efficacy. Our study suggests that RFID and SAVI Scout also perform similarly to one another. Physicians and institutions may consider more nuanced features of each localization system rather than performance alone when choosing a wire-free alternative.

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References

  1. 1.

    Srour MK, Kim S, Amersi F, Giuliano AE, Chung A (2020) Comparison of wire localization, radioactive seed, and Savi scout® radar for management of surgical breast disease. Breast J 26(3):406–413

    Article  Google Scholar 

  2. 2.

    DiNome ML, Kusske AM, Attai DJ, Fischer CP, Hoyt AC (2019) Microchipping the breast: an effective new technology for localizing non-palpable breast lesions for surgery. Breast Cancer Res Treat 175(1):165–170

    Article  Google Scholar 

  3. 3.

    Mango V, Ha R, Gomberawalla A, Wynn R, Feldman S (2016) Evaluation of the SAVI SCOUT surgical guidance system for localization and excision of nonpalpable breast lesions: a feasibility study. AJR 207(4):W69–W72

    Article  Google Scholar 

  4. 4.

    Gray RJ, Salud C, Nguyen K, Dauway E, Friedland J, Berman C, Peltz E, Whitehead G, Cox CE (2001) Randomized prospective evaluation of a novel technique for biopsy or lumpectomy of nonpalpable breast lesions: radioactive seed versus wire localization. Ann Surg Oncol 8(9):711–715

    CAS  Article  Google Scholar 

  5. 5.

    McGhan LJ, McKeever SC, Pockaj BA, Wasif N, Giurescu ME, Walton HA, Gray RJ (2011) Radioactive seed localization for nonpalpable breast lesions: review of 1,000 consecutive procedures at a single institution. Ann Surg Oncol 18:3096–3101

    Article  Google Scholar 

  6. 6.

    Gray RJ, Pockaj BA, Karstaedt PJ, Roarke MC (2004) Radioactive seed localization of nonpalpable breast lesions is better than wire localization. Am J Surg 188(4):377–380

    Article  Google Scholar 

  7. 7.

    Hughes JH, Mason MC, Gray RJ, McLaughlin SA, Degnim AC, Fulmer JT, Pockaj BA, Karstaedt PJ, Roarke MC (2008) A multi-site validation trial of radioactive seed localization as an alternative to wire localization. Breast J 14(2):153–157

    Article  Google Scholar 

  8. 8.

    Dryden MJ, Dogan BE, Fox P, Wang C, Black DM, Hunt K, Yang WT (2016) Imaging factors that influence surgical margins after preoperative 125I radioactive seed localization of breast lesions: comparison with wire localization. AJR 206(5):1112–1118

    Article  Google Scholar 

  9. 9.

    Mango VL, Wynn RT, Feldman S, Friedlander L, Desperito E, Patel SN, Gomberawalla A, Ha R (2017) Beyond wires and seeds: reflector-guided breast lesion localization and excision. Radiology 284(2):365–371

    Article  Google Scholar 

  10. 10.

    Jadeja PH, Mango V, Patel S, Friedlander L, Desperito E, Ayala-Bustamante E, Wynn R, Chen-Seetoo M, Taback B, Feldman S, Ha R (2018) Utilization of multiple SAVI SCOUT surgical guidance system reflectors in the same breast: a single-institution feasibility study. Breast J 24(4):531–534

    Article  Google Scholar 

  11. 11.

    Patel SN, Mango VL, Jadeja P, Friedlander L, Desperito E, Wynn R, Feldman S, Ha R (2018) Reflector-guided breast tumor localization versus wire localization for lumpectomies: A comparison of surgical outcomes. Clin Imaging 47:14–17

    Article  Google Scholar 

  12. 12.

    Cox CE, Russell S, Prowler V, Carter E, Beard A, Mehindru A, Blumencranz P, Allen K, Portillo M, Whitworth P, Funk K, Barone J, Norton D, Schroeder J, Police A, Lin E, Combs F, Schnabel F, Toth H, Lee J, Anglin B, Nguyen M, Canavan L, Laidley A, Warden MJ, Prati R, King J, Shivers SC (2016) A prospective, single arm, multi-site, clinical evaluation of a nonradioactive surgical guidance technology for the location of nonpalpable breast lesions during excision. Ann Surg Oncol 23(10):3168–3174

    Article  Google Scholar 

  13. 13.

    Cox CE, Garcia-Henriquez N, Glancy MJ, Whitworth P, Cox JM, Themar-Geck M, Prati R, Jung M, Russell S, Appleton K, King J, Shivers SC (2016) Pilot study of a new nonradioactive surgical guidance technology for locating nonpalpable breast lesions. Ann Surg Oncol 23(6):1824–1830

    Article  Google Scholar 

  14. 14.

    Malteri W, Holtschmidt J, Thangarajah F, Mallmann P, Krug B, Warm M, Eichler C (2019) First reported use of the Faxitron LOCalizer™ radiofrequency identification (RFID) system in Europe: a feasibility trial, surgical guide and review for non-palpable breast lesions. In Vivo 33(5):1559–1564

    Article  Google Scholar 

  15. 15.

    McGugin C, Spivey T, Coopey S, Smith B, Kelly B, Gadd M, Hughes K, Dontchos B, Specht M (2019) Radiofrequency identification tag localization is comparable to wire localization for non-palpable breast lesions. Breast Cancer Res Treat 177(3):735–739

    Article  Google Scholar 

Download references

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Correspondence to Maggie L. DiNome.

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Lee, M.K., Sanaiha, Y., Kusske, A.M. et al. A comparison of two non-radioactive alternatives to wire for the localization of non-palpable breast cancers. Breast Cancer Res Treat 182, 299–303 (2020). https://doi.org/10.1007/s10549-020-05707-1

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Keywords

  • Radiofrequency tag
  • SAVI scout
  • Breast surgery
  • Wire-free localization
  • Localizer