title: Evaluation of a hydrogel based breast biopsy marker (HydroMARK®) as an alternative to wire and radioactive seed localization for non-palpable breast lesions.
abstract: OBJECTIVE
  HydroMARK® is a newly available biopsy marker for image-guided needle biopsies of non-palpable breast lesions. Objective was to determine if the marker could be utilized independently for lesion localization using intra-operative ultrasound alone.
  
  
  METHODS
  A single institution retrospective review identified patients who underwent surgical excision of breast lesions after placement of the HydroMARK®. Endpoints included intra-operative visualization of the marker, successful excision of the lesion, and presence of the marker on specimen radiograph.
  
  
  RESULTS
  The study included 31 lesions in 25 patients. Twenty-nine (93.6%) HydroMARKSs® were adequately visualized by intra-operative ultrasound. Intra-operative ultrasound without pre-operative placement of a localizing device was successful for localization in six cases (19.4%). Intra-operative difficulties were encountered in 16 of 31 (51.6%) procedures. This included either extrusion of the marker when the biopsy tract was transected in 14 (45.2%) cases or migration of the marker prior to the procedure in two (6.4%) cases. The marker was visualized on specimen radiograph in 15 (48.4%) cases.
  
  
  CONCLUSIONS
  While intraoperative sonographic visibility was excellent, a large number of excisions were associated with extrusion of the marker. Modifications are needed to improve acceptability of this marker for intra-operative localization independent of pre-operative wire or seed localization.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Klein
authors.forename: Julie A
authors.initials: JA
authors.lastname: Mook
authors.forename: David M
authors.initials: DM
authors.lastname: Euhus
authors.forename: Roshni
authors.initials: R
authors.lastname: Rao
authors.forename: Ralph T
authors.initials: RT
authors.lastname: Wynn
authors.forename: Amy B
authors.initials: AB
authors.lastname: Eastman
authors.forename: A Marilyn
authors.initials: AM
authors.lastname: Leitch
mesh_terms: D044963:Biopsy, Fine-Needle / Q000295:instrumentation*; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D020100:Hydrogels; D007432:Intraoperative Period; D016015:Logistic Models; D053783:Magnetic Resonance Imaging, Interventional; D015412:Mastectomy, Segmental; D011092:Polyethylene Glycols; D012189:Retrospective Studies; D014025:Titanium; D018084:Ultrasonography, Interventional
chemical_list: D020100:Hydrogels; D011092:Polyethylene Glycols; D014025:Titanium