Imaging factors that influence surgical margins after preoperative 125I radioactive seed localization of breast lesions: Comparison with wire localization

Mark J. Dryden, Basak E. Dogan, Patricia Fox, Cuiyan Wang, Dalliah M. Black, Kelly Hunt, Wei Tse Yang

Research output: Contribution to journalArticle

13 Citations (Scopus)

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. MATERIALS AND 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). CONCLUSION. 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.

Original languageEnglish (US)
Pages (from-to)1112-1118
Number of pages7
JournalAmerican Journal of Roentgenology
Volume206
Issue number5
DOIs
StatePublished - May 1 2016

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Seeds
Breast
Mastectomy
Odds Ratio
Margins of Excision

Keywords

  • I seed localization
  • Breast cancer
  • Mammography
  • Ultrasound-guided wire localization
  • Wire localization

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Imaging factors that influence surgical margins after preoperative 125I radioactive seed localization of breast lesions : Comparison with wire localization. / Dryden, Mark J.; Dogan, Basak E.; Fox, Patricia; Wang, Cuiyan; Black, Dalliah M.; Hunt, Kelly; Yang, Wei Tse.

In: American Journal of Roentgenology, Vol. 206, No. 5, 01.05.2016, p. 1112-1118.

Research output: Contribution to journalArticle

Dryden, Mark J. ; Dogan, Basak E. ; Fox, Patricia ; Wang, Cuiyan ; Black, Dalliah M. ; Hunt, Kelly ; Yang, Wei Tse. / Imaging factors that influence surgical margins after preoperative 125I radioactive seed localization of breast lesions : Comparison with wire localization. In: American Journal of Roentgenology. 2016 ; Vol. 206, No. 5. pp. 1112-1118.
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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. MATERIALS AND 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). CONCLUSION. 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.",
keywords = "I seed localization, Breast cancer, Mammography, Ultrasound-guided wire localization, Wire localization",
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T1 - Imaging factors that influence surgical margins after preoperative 125I radioactive seed localization of breast lesions

T2 - Comparison with wire localization

AU - Dryden, Mark J.

AU - Dogan, Basak E.

AU - Fox, Patricia

AU - Wang, Cuiyan

AU - Black, Dalliah M.

AU - Hunt, Kelly

AU - Yang, Wei Tse

PY - 2016/5/1

Y1 - 2016/5/1

N2 - 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. MATERIALS AND 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). CONCLUSION. 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.

AB - 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. MATERIALS AND 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). CONCLUSION. 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.

KW - I seed localization

KW - Breast cancer

KW - Mammography

KW - Ultrasound-guided wire localization

KW - Wire localization

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