Annals of Surgical Oncology

, Volume 24, Issue 12, pp 3567–3573 | Cite as

Radioactive Seed Localization Versus Wire-Guided Localization for Nonpalpable Breast Cancer: A Cost and Operating Room Efficiency Analysis

  • Yimeng Zhang
  • Jean Seely
  • Erin Cordeiro
  • Joshua Hefler
  • Kednapa Thavorn
  • Mukta Mahajan
  • Sue Domina
  • Jon Aro
  • Andrea Marie Ibrahim
  • Angel Arnaout
  • Denis Gravel
  • Carolyn Nessim
Breast Oncology

Abstract

Background

This study aimed to compare the cost and resource use between our first-year experience using breast-conserving surgery (BCS) with radioactive seed localization (RSL) and the previous-year standard practice of BCS with wire-guided localization (WGL) for patients with nonpalpable breast cancer at a large Canadian tertiary center.

Methods

For this retrospective cohort study, data for BCS cases with RSL was collected from 1 April 2015 to 31 March 2016 and for BCS cases with WGL from 1 April 2014 to 31 March 2015.

Results

The study compared 153 WGL patients with 194 RSL patients. The two groups had no significant demographic differences. The average cost per patient for RSL, including opportunity costs, was $250.90 versus $1130.41 for WGL. Dedicated allocated radiology appointments to RSL increased (9 per day), and fewer radiologists were required for these procedures per day. Patients were transported to the operating room more quickly for RSL procedures (120 vs. 254 min; p < 0.001). Fewer vasovagal reactions occurred after insertion of RSL versus WGL (p = 0.05). No significant differences were observed in terms of surgical time, specimen volume, positive margins, or margin reexcision rates. No significant differences in postoperative complication rates were observed.

Conclusions

In this study, RSL had lower costs than WGL, allowed for more efficient use of radiology scheduling and resources, and had shorter wait times for patients on their day of surgery. In addition, RSL led to fewer vasovagal reactions at insertion. Therefore, RSL should be used instead of WGL given the reduced cost, decreased need of human resources, improved efficiency, and potential benefits to the patient experience.

Notes

Acknowledgment

The authors acknowledge Sasha Van Katwyk, a health economist at the Ottawa Hospital Research Institute, for his contributions to the cost comparison calculations.

DISCLOSURE

There are no conflicts of interest.

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Copyright information

© Society of Surgical Oncology 2017

Authors and Affiliations

  • Yimeng Zhang
    • 1
  • Jean Seely
    • 2
  • Erin Cordeiro
    • 1
  • Joshua Hefler
    • 3
  • Kednapa Thavorn
    • 4
    • 5
    • 6
  • Mukta Mahajan
    • 2
  • Sue Domina
    • 2
  • Jon Aro
    • 7
  • Andrea Marie Ibrahim
    • 4
  • Angel Arnaout
    • 1
  • Denis Gravel
    • 8
  • Carolyn Nessim
    • 1
  1. 1.Division of General Surgery, The Ottawa HospitalUniversity of OttawaOttawaCanada
  2. 2.Department of Diagnostic Radiology, The Ottawa HospitalUniversity of OttawaOttawaCanada
  3. 3.Faculty of MedicineUniversity of OttawaOttawaCanada
  4. 4.Ottawa Hospital Research InstituteThe Ottawa HospitalOttawaCanada
  5. 5.School of Epidemiology, Public Health and Preventive MedicineUniversity of OttawaOttawaCanada
  6. 6.Institute of Clinical and Evaluative Sciences (ICES@Ottawa)TorontoCanada
  7. 7.Department of Radiation and Laser SafetyThe Ottawa HospitalOttawaCanada
  8. 8.Department of Pathology and Laboratory Medicine, The Ottawa HospitalUniversity of OttawaOttawaCanada

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