[Radioguided surgery for therapeutic excision of nonpalpable breast cancer].
BACKGROUND
Intratumoral injection of nanocolloid for lymphatic mapping enables therapeutic excision of clinically occult breast cancer with the aid of a gamma ray detection probe.


OBJECTIVE
The aim of this study was to determine the success rate of radioguided tumor excision in addition to a guide wire and to identify factors predicting clear margins.


METHODS
Sixty five consecutive patients with invasive occult breast cancer underwent radioguided tumor excision after intratumoral injection of 99 mTc-nanocolloid guided by ultrasound or stereotaxis. A localization wire was inserted; subsequently scintigraphy was performed (group 1). Results were compared with retrospective data from 67 consecutive patients who underwent therapeutic wire-directed excision alone (group 2). Factors predicting clear margin (>1 mm) were determined in a logistic regression model.


RESULTS
Adequate margins were obtained in 83 (group 1) and 64% (group 2; p = 0.014) respectively. The invasive component was performed in 4 and 14 patients, respectively. Factors predictive of clear margins were decreasing pathologic tumor diameter (p = 0.035), increasing weight of specimen (p = 0.046), absence of micro-calcifications (p = 0.004), and absence of carcinoma in situ component (p = 0.024). Radioguided excision was an independent predictor of complete excision of the invasive component (p = 0.012).


CONCLUSIONS
Application of radioguided surgery combined with wire localization seems to improve outcome of therapeutic excision of non-palpable invasive breast cancer compared to wire-directed excision alone.
Hospital de Oncología, CMN Siglo XXI, IMSS, México D.F., México. gal61@prodigy.net.mc
J Francisco
JF
Gallegos-Hernández
Pieter J
PJ
Tanis
Omgo E
OE
Nieweg
E
E
Duerloo
Renato
R
Valdés-Olmos
Emeil J Th
EJ
Rutgers
Bin B
BB
Kroon
D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D015641:Radiography, Interventional; D012189:Retrospective Studies