title: [Placement of metal clips as a means for identifying the tumor bed in women post lumpectomy].
abstract: BACKGROUND
  Surgical clips inserted during breast-conserving surgery [BCS] serve as a surrogate of the lumpectomy cavity. Visualization of the surgical clips by imaging prior to radiotherapy (RT), during treatment planning, aids in designing the treatment volume for breast irradiation.
  
  
  OBJECTIVE
  The aim of this study was to evaluate whether there is a distinct difference in the tendency to insert a metal clip during BCS, that is related to the hospital where the procedure was performed and to evaluate whether there are differences in the boost planning treatment volume (PTV).
  
  
  METHODS
  This is a retrospective study. The records of all patients treated by adjuvant RT after BCS were reviewed. Boost PTV was calculated in cubic centimeters (ccj and compared between the groups.
  
  
  RESULTS
  Of the 143 patients included in the study, 31% were operated on in private hospitals and 69% were operated on in public hospitals. A statistically significant difference was found in clip insertion in patients treated in private hospitals compared to public hospitals. No statistical differences were found in the boost PTV size between the groups (p = 0.448). A similar difference was found when comparing tertiary public centers to smaller secondary public centers.
  
  
  CONCLUSIONS
  Our study demonstrates a higher tendency to insert metal clips during BCS in private hospitals as compared to public hospitals. There were no differences in the tumor bed PTV in patients with or without surgical clips.
authors.forename: Adi
authors.initials: A
authors.lastname: Lahav
authors.forename: Roxolyana
authors.initials: R
authors.lastname: Bortnyak-Abdah
authors.forename: Orit
authors.initials: O
authors.lastname: Kaidar-Person
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D016304:Hospitals, Private / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D015412:Mastectomy, Segmental / Q000379:methods*; D008670:Metals; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant / Q000379:methods; D012189:Retrospective Studies; D013525:Surgical Instruments
chemical_list: D008670:Metals