title: Radioactive seed localization is the preferred technique in nonpalpable breast cancer compared with wire-guided localization and radioguided occult lesion localization.
abstract: OBJECTIVE
  Three commonly used techniques for localization of nonpalpable breast cancer are radioactive seed localization (RSL), wire-guided localization (WGL) and radioguided occult lesion localization (ROLL). In this study, we analysed the surgical margins of these three techniques.
  
  
  METHODS
  Women diagnosed with nonpalpable breast cancer undergoing breast-conserving surgery with one of the above-mentioned techniques were retrospectively included. The primary outcome parameter was tumour-free margin rate. Secondary outcomes were re-excision rate, recurrence of disease and volume of removed tissue.
  
  
  RESULTS
  In total, 272 women were included in whom RSL (n=69), WGL (n=76) or ROLL (n=137) was performed. RSL showed a higher tumour-free margin rate [64 (92.8%)] compared with WGL [51 (67.1%)] and ROLL [113 (82.5%)] (P=0.001). In our multivariable analysis, RSL showed a higher tumour-free margin rate as well compared with WGL (P=0.036) and ROLL (P=0.049). Also, fewer re-excisions were encountered using RSL [5 (7.2%)] compared with WGL [13 (17.1%)] and ROLL [15 (10.9%)] (P=0.171). In 11 patients (WGL n=2, ROLL n=9), recurrence of disease occurred, despite a radical excision. The mean resection volumes were comparable within the three groups.
  
  
  CONCLUSIONS
  RSL results in a higher tumour-free margin rate in nonpalpable breast tumours compared with WGL and ROLL. Therefore, we prefer using RSL in nonpalpable breast tumours.
authors.affiliation: Departments of aPlastic Surgery bInnovation and Science cSurgery dNuclear Medicine, Isala, Zwolle, The Netherlands.
authors.forename: Carla I J M
authors.initials: CI
authors.lastname: Theunissen
authors.forename: Esther A Z
authors.initials: EA
authors.lastname: Rust
authors.forename: Mireille A
authors.initials: MA
authors.lastname: Edens
authors.forename: Caroline
authors.initials: C
authors.lastname: Bandel
authors.forename: Janneke G
authors.initials: JG
authors.lastname: Van't Ooster-van den Berg
authors.forename: Piet L
authors.initials: PL
authors.lastname: Jager
authors.forename: Eva M
authors.initials: EM
authors.lastname: Noorda
authors.forename: Anne Brecht
authors.initials: AB
authors.lastname: Francken
mesh_terms: D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental / Q000295:instrumentation / Q000379:methods*; D012008:Recurrence