title: The effect of multiple wire localization in breast conservation.
abstract: Variability exists regarding the surgical technique in breast conservation therapy. The purpose of this project was to determine differences between single (SH) or flanking (FH) hooked needle localization wires used for nonpalpable breast lesions. We retrospectively reviewed 201 female  patients at a single institution from 2004 to 2008. All patients had biopsy-proven ductal carcinoma in situ or invasive disease. Comparisons were made in regard to margin status, reoperation, completion mastectomy, size of lesion, and breast specimen volume. SH was placed in 122 patients  (61%) and FH in 79 patients (39%). In SH, 23 patients (18%) had positive margins and 31 patients (25%) had reoperations as compared with 31 patients (25%) with positive margin and 36 patients (44%) in the FH cohort (P = 0.039 and 0.0037). Average lesion size and volume resected was  1.5 cm and 137 cm(3) in SH and 2.85 cm and 188 cm(3) in FH, respectively (P = 0.0001 and 0.006). Positive margins were associated with lesion size and not volume of tissue excised. The FH technique was associated with more positive margins, reoperation, and completion  mastectomy.
authors.affiliation: University of Tennessee Medical Center, Department of Surgery, 1924 Alcoa Highway, Knoxville, TN 37920, USA. michellefillionweeden@gmail.com
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Fillion
authors.forename: Emily Anne
authors.initials: EA
authors.lastname: Black
authors.forename: Kathleen B
authors.initials: KB
authors.lastname: Hudson
authors.forename: Garnetta
authors.initials: G
authors.lastname: Morin-Ducote
authors.forename: John L
authors.initials: JL
authors.lastname: Bell
authors.forename: Keith D
authors.initials: KD
authors.lastname: Gray
authors.forename: James M
authors.initials: JM
authors.lastname: Lewis
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008327:Mammography; D015412:Mastectomy, Segmental / Q000295:instrumentation*; D008875:Middle Aged; D009367:Neoplasm Staging; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome