Official websites use. Share sensitive information only on official, secure websites. Most breast cancers are small and can be treated using breast-conserving surgery. Since these tumors are non-palpable, they require a localization step that helps the surgeon to decide which tissue needs to be removed.
The oldest localization technique is a guidewire placed into the tumor before surgery, usually using ultrasound or mammography. Afterwards, the surgeon removes the tissue around the wire tip. Therefore, new techniques have been developed but most of them have not yet been examined in large, prospective, multicenter studies. In this review, we discuss all available techniques and present the MELODY study that will investigate their safety, with a focus on patient, surgeon, and radiologist preference.
Background: Surgical excision of a non-palpable breast lesion requires a localization step. Among available techniques, wire-guided localization WGL is most commonly used. Other techniques radioactive, magnetic, radar or radiofrequency-based, and intraoperative ultrasound have been developed in the last two decades with the aim of improving outcomes and logistics. Methods: We performed a systematic review on localization techniques for non-palpable breast cancer.
Results: For most techniques, oncological outcomes such as lesion identification and clear margin rate seem either comparable with or better than for WGL, but evidence is limited to small cohort studies for some of the devices. Intraoperative ultrasound is associated with significantly higher negative margin rates in meta-analyses of randomized clinical trials RCTs. Conclusions: Large studies with an additional focus on patient, surgeon, and radiologist preference are necessary.
Keywords: breast cancer, localization technique, non-palpable lesion, intraoperative ultrasound, wire-guided localization, magnetic seed, radioactive seed, radar reflector, radiofrequency identification tag. Surgical excision of a non-palpable breast lesion requires some form of breast localization device. Despite multiple available solutions, a majority of units use wire-guided localization WGL due to the high efficacy and low cost [ 1 , 2 ]. Other techniques, e. While WGL has clear benefits in terms of cost, efficacy, and a trained workforce, it also carries several weaknesses, including logistical difficulties due to the need of placement on the day of surgery and the potential for displacement.
