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Annals of Surgical Oncology

, Volume 23, Issue 1, pp 38–43 | Cite as

Intraoperative Ultrasound-Guided Lumpectomy Versus Mammographic Wire Localization for Breast Cancer Patients After Neoadjuvant Treatment

  • Isabel T. Rubio
  • Antonio Esgueva-Colmenarejo
  • Martin Espinosa-Bravo
  • Juan Pablo Salazar
  • Ignacio Miranda
  • Vicente Peg
Breast Oncology

Abstract

Background

Intraoperative ultrasound (IOUS)-guided lumpectomy in early breast cancer has shown advantages over other techniques. However, the use of IOUS has been less explored after neoadjuvant treatment (NAT). This study aimed to compare IOUS- and wire localization (WL)-guided surgery in breast cancer patients after NAT.

Methods

The study enrolled patients treated with NAT who underwent breast-conserving surgery (BCS) between July 2008 and December 2012. For the patients with a hydrogel marker or residual tumor visible on ultrasound, an IOUS-guided surgery was performed (IOUS group). The patients with a standard marker or hydrogel marker not visible on ultrasound underwent a WL-guided surgery (WL group).

Results

The study investigated 214 patients: 145 (67.8 %) in the IOUS group and 69 (32.2 %) in the WL group. The patient and tumor characteristics were comparable between the two groups. For the patients who had a pathologic complete response (pCR) or microscopic disease, the volume excised was lower in the IOUS group (p = 0.03). The rate of reexcision for positive or close margins was similar in the two groups (p = 0.80). After a median follow-up period of 43 months, the local recurrence rates did not differ significantly between the two groups.

Conclusions

Compared with WL surgery, IOUS seems to lower the volume of resection in patients with pCR or minimal microscopic disease after NAT without compromising margins and local recurrences. BCS can easily be achieved with IOUS for patients with a good response after NAT.

Keywords

Positive Margin Negative Margin Close Margin Wire Localization Radioactive Seed 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Society of Surgical Oncology 2015

Authors and Affiliations

  • Isabel T. Rubio
    • 1
  • Antonio Esgueva-Colmenarejo
    • 1
  • Martin Espinosa-Bravo
    • 1
  • Juan Pablo Salazar
    • 2
  • Ignacio Miranda
    • 2
  • Vicente Peg
    • 3
  1. 1.Breast Surgical Oncology UnitHospital Universitario Vall d’HebronBarcelonaSpain
  2. 2.Department of RadiologyHospital Universitario Vall d’HebronBarcelonaSpain
  3. 3.Department of PathologyHospital Universitario Vall d’HebronBarcelonaSpain

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