title: Outcomes of multiple wire localization for larger breast cancers: when can mastectomy be avoided?
abstract: BACKGROUND
  Mastectomy is often recommended when mammography shows a breast cancer with extensive calcifications. We wished to determine whether the use of multiple localizing wires to guide lumpectomy in this setting was associated with increased rates of breast conservation. We also wanted to identify factors that predicted a poor chance of successful lumpectomy, to avoid multiple lumpectomy attempts in a patient who would ultimately require mastectomy.
  
  
  METHODS
  Records of 153 women with breast cancer who underwent lumpectomy for larger lesions that required multiple wire localization and 196 controls who required only single wire localization were reviewed retrospectively. The number of localizing wires, specimen volume, largest specimen dimension, number of surgical procedures, and rates of breast conservation were scored.
  
  
  RESULTS
  Seventy-seven percent of patients requiring multiple wire localization had successful breast conservation, compared with 90% of those needing only single wire localization. Only 28% of multiple wire patients required more than 1 excision to achieve clear margins, compared with 36% of single wire patients (p < 0.01).
  
  
  CONCLUSIONS
  Breast conservation is possible in the great majority of breast cancer patients whose mammographic lesions require multiple localizing wires for excision. The use of multiple wires can decrease the number of procedures required to obtain clear lumpectomy margins.
authors: Division of Surgical Oncology, Massachusetts General Hospital, Boston, MA 02115, USA.
authors: Laurie J
authors: LJ
authors: Kirstein
authors: Elizabeth
authors: E
authors: Rafferty
authors: Michelle C
authors: MC
authors: Specht
authors: Richard H
authors: RH
authors: Moore
authors: Alphonse G
authors: AG
authors: Taghian
authors: Kevin S
authors: KS
authors: Hughes
authors: Michele A
authors: MA
authors: Gadd
authors: Barbara L
authors: BL
authors: Smith
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000601:surgery*; D044584:Carcinoma, Ductal / Q000000981:diagnostic imaging / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000601:surgery*; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008327:Mammography; D008408:Mastectomy; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies