title: Ultrasound-guided lumpectomy of nonpalpable breast cancer versus wire-guided resection: a randomized clinical trial.
abstract: BACKGROUND
  The wire-guided excision of nonpalpable breast cancer often results in tumor resections with inadequate margins. This prospective, randomized trial was undertaken to investigate whether intraoperative ultrasound (US) guidance enables a better margin clearance than the wire-guided technique in the breast-conserving treatment of nonpalpable breast cancers.
  
  
  METHODS
  Patients with a preoperative histological diagnosis of nonpalpable breast cancer that could be visualized both with US and mammography were included. Patients were randomized to undergo either a wire-guided or a US-guided excision. Adequate margins were defined as >or=1 mm.
  
  
  RESULTS
  Of 49 included patients, 23 were assigned to undergo wire-guided excision and 26 to undergo US-guided excision. One patient crossed over to US-guided excision after inadvertent wire displacement. Mean tumor diameter, specimen weight, and operating time were similar in both groups. The excision was adequate in 24 (89%) of 27 US-guided excisions and 12 (55%) of 22 wire-guide excisions (P =.007).
  
  
  CONCLUSIONS
  US-guided excision seems to be superior to wire-guided excision with respect to margin clearance of mammographically detected and US-visible nonpalpable breast cancers. Patients do not have to undergo the unpleasant wire placement before surgery.
authors.affiliation: Department of Surgery, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands.
authors.forename: Frans D
authors.initials: FD
authors.lastname: Rahusen
authors.forename: Andre J A
authors.initials: AJ
authors.lastname: Bremers
authors.forename: Hans F J
authors.initials: HF
authors.lastname: Fabry
authors.forename: A H M Taets
authors.initials: AH
authors.lastname: van Amerongen
authors.forename: Rob P A
authors.initials: RP
authors.lastname: Boom
authors.forename: S
authors.initials: S
authors.lastname: Meijer
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008327:Mammography; D015412:Mastectomy, Segmental / Q000379:methods*; D011446:Prospective Studies; D016217:Ultrasonography, Mammary