title: A multi-site validation trial of radioactive seed localization as an alternative to wire localization.
abstract: This study aims to validate radioactive seed localization (RSL) as an alternative to wire localization (WL) in the operative excision of nonpalpable breast lesions. Eligible patients were recruited sequentially. A sample of 99 patients treated with WL was compared to the next 383 patients treated with RSL. Margins were considered "negative" if > or =2 mm from in-situ and invasive disease. Pain and convenience scores were recorded on a 10-point scale. Patient characteristics and histology were similar. The lesion and localization device were retrieved in all patients. Margins of the first specimen were negative in 73% of RSL patients, versus 54% of WL patients (p < 0.001). A second operation was required in 8% of RSL patients to achieve negative margins, versus 25% of WL patients (p < 0.001). Pain scores were not statistically different. However, the RSL group had higher convenience scores (p = 0.015). RSL is safe, effective, and compared to WL, reduces the rates of intraoperative re-excision and reoperation for positive margins by 68%. Patient satisfaction is improved with RSL. We strongly favor RSL over WL.
authors.affiliation: Department of Surgery, Mayo Clinic, Scottsdale, Arizona 85259, USA.
authors.forename: Jenevieve H
authors.initials: JH
authors.lastname: Hughes
authors.forename: Mark C
authors.initials: MC
authors.lastname: Mason
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Gray
authors.forename: Sarah A
authors.initials: SA
authors.lastname: McLaughlin
authors.forename: Amy C
authors.initials: AC
authors.lastname: Degnim
authors.forename: Jack T
authors.initials: JT
authors.lastname: Fulmer
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Pockaj
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Karstaedt
authors.forename: Michael C
authors.initials: MC
authors.lastname: Roarke
mesh_terms: D001706:Biopsy / Q000379:methods*; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D008327:Mammography; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D011877:Radionuclide Imaging; D012086:Reoperation
chemical_list: D007457:Iodine Radioisotopes