title: Imaging Factors That Influence Surgical Margins After Preoperative 125I Radioactive Seed Localization of Breast Lesions: Comparison With Wire Localization.
abstract: OBJECTIVE
  The objective of this study was to compare the potential influence of imaging variables on surgical margins after preoperative radioactive seed localization (RSL) and wire localization (WL) techniques.
  
  
  METHODS
  A total of 565 women with 660 breast lesions underwent RSL or WL between May 16, 2012, and May 30, 2013. Patient age, lesion type (mass, calcifications, mass with associated calcifications, other), lesion size, number of seeds or wires used, surgical margin status (close positive or negative margins), and reexcision and mastectomy rates were recorded.
  
  
  RESULTS
  Of 660 lesions, 127 (19%) underwent RSL and 533 (81%) underwent WL preoperatively. Mean lesion size was 1.8 cm in the RSL group and 1.8 cm in the WL group (p = 0.35). No difference in lesion type was identified in the RSL and WL groups (p = 0.63). RSL with a single seed was used in 105 of 127 (83%) RSLs compared with WL with a single wire in 349 of 533 (65%) WLs (p = 0.0003). The number of cases with a close positive margin was similar for RSLs (26/127, 20%) and WLs (104/533, 20%) (p = 0.81). There was no difference between the RSL group and the WL group in close positive margin status (20% each, p = 0.81), reexcision rates (20% vs 16%, respectively; p = 0.36), or mastectomy rates (6% each, p = 0.96). Lesions containing calcifications were more likely to require more than one wire (odds ratio [OR], 4.44; 95% CI, 2.8-7.0) or more than one seed (OR, 7.03; 95% CI, 1.6-30.0) when compared with masses alone (p < 0.0001). Increasing lesion size and the presence of calcifications were significant predictors of positive margins, whereas the use of more than one wire or seed was not (OR, 0.9; 95% CI, 0.5-1.5) (p = 0.75).
  
  
  CONCLUSIONS
  Close positive margin, reexcision, and mastectomy rates remained similar in the WL group and RSL group. The presence of calcifications and increasing lesion size increased the odds of a close positive margin in both the WL and RSL groups, whereas the use of one versus more than one seed or wire did not.
authors.affiliation: 1 Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350, Houston, TX 77030.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Dryden
authors.affiliation: 1 Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350, Houston, TX 77030.
authors.forename: Basak E
authors.initials: BE
authors.lastname: Dogan
authors.affiliation: 2 Department of Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, TX.
authors.forename: Patricia
authors.initials: P
authors.lastname: Fox
authors.affiliation: 1 Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350, Houston, TX 77030.|3 Shandong Medical Imaging Research Institute, Jinan, Shandong, China.
authors.forename: Cuiyan
authors.initials: C
authors.lastname: Wang
authors.affiliation: 4 Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX.
authors.forename: Dalliah M
authors.initials: DM
authors.lastname: Black
authors.affiliation: 4 Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX.
authors.forename: Kelly
authors.initials: K
authors.lastname: Hunt
authors.affiliation: 1 Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350, Houston, TX 77030.
authors.forename: Wei Tse
authors.initials: WT
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000473:pathology* / Q000601:surgery; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D057918:Fiducial Markers; D006801:Humans; D008327:Mammography / Q000379:methods*; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D016217:Ultrasonography, Mammary / Q000379:methods*; D055815:Young Adult
keywords: 125I seed localization; breast cancer; mammography; ultrasound-guided wire localization; wire localization