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Comparison of outcomes of surgeon-performed intraoperative ultrasonography-guided wire localization and preoperative wire localization in nonpalpable breast cancer patients undergoing breast-conserving surgery: A retrospective cohort study.

Abstract This study aimed to determine the efficacy of intraoperative ultrasonography-guided wire localization guided breast-conserving surgery (BCS) for nonpalpable breast cancer and compare it to conventional preoperative wire localization (PWL) guided surgery.We retrospectively analyzed the medical charts of 214 consecutive nonpalpable breast cancer patients who underwent BCS using intraoperative ultrasonography-guided wire localization by a surgeon (IUWLS) and PWL, between April 2013 and March 2017. Positive surgical margins, reexcision rates, and resection volumes were investigated.Of the total cohort, 124 patients underwent BCS with IUWLS and 90 patients with PWL. The following did not differ between the IUWLS and PWL groups: positive margin status, re-excision rate, conversion rate, permanent positive margin status, reoperation rate, median optimal resection volume (ORV), median total resection volume (TRV), and median closest tumor-free margin. Rather, median (range) widest tumor-free margin was significantly smaller in the IUWLS group (9 mm [5-12]) than in the PWL group (14 mm [9-20]; P = .003]). Median (range) calculated resection ratio (CRR) was significantly lower in the IUWLS group (1.67 [0.87-9.38]) than in the PWL group (4.83 [1.63-21.04]; P = .02).In nonpalpable breast cancer patients undergoing BCS, IUWLS showed positive resection margins and reexcision rates equivalent to those of the conventional PWL method. Additionally, excision volume and widest tumor-free margin were smaller with IUWLS, confirming that healthy breast tissue is less likely to be resected with this method. Our results suggest that IUWLS offers an excellent alternative to PWL, while avoiding PWL-induced patient discomfort.
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Mayor MeshTerms

Mastectomy, Segmental

Keywords
Journal Title medicine
Publication Year Start




PMID- 29390405
OWN - NLM
STAT- MEDLINE
DCOM- 20180212
LR  - 20180212
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 50
DP  - 2017 Dec
TI  - Comparison of outcomes of surgeon-performed intraoperative ultrasonography-guided
      wire localization and preoperative wire localization in nonpalpable breast cancer
      patients undergoing breast-conserving surgery: A retrospective cohort study.
PG  - e9340
LID - 10.1097/MD.0000000000009340 [doi]
AB  - This study aimed to determine the efficacy of intraoperative
      ultrasonography-guided wire localization guided breast-conserving surgery (BCS)
      for nonpalpable breast cancer and compare it to conventional preoperative wire
      localization (PWL) guided surgery.We retrospectively analyzed the medical charts 
      of 214 consecutive nonpalpable breast cancer patients who underwent BCS using
      intraoperative ultrasonography-guided wire localization by a surgeon (IUWLS) and 
      PWL, between April 2013 and March 2017. Positive surgical margins, reexcision
      rates, and resection volumes were investigated.Of the total cohort, 124 patients 
      underwent BCS with IUWLS and 90 patients with PWL. The following did not differ
      between the IUWLS and PWL groups: positive margin status, re-excision rate,
      conversion rate, permanent positive margin status, reoperation rate, median
      optimal resection volume (ORV), median total resection volume (TRV), and median
      closest tumor-free margin. Rather, median (range) widest tumor-free margin was
      significantly smaller in the IUWLS group (9 mm [5-12]) than in the PWL group (14 
      mm [9-20]; P = .003]). Median (range) calculated resection ratio (CRR) was
      significantly lower in the IUWLS group (1.67 [0.87-9.38]) than in the PWL group
      (4.83 [1.63-21.04]; P = .02).In nonpalpable breast cancer patients undergoing
      BCS, IUWLS showed positive resection margins and reexcision rates equivalent to
      those of the conventional PWL method. Additionally, excision volume and widest
      tumor-free margin were smaller with IUWLS, confirming that healthy breast tissue 
      is less likely to be resected with this method. Our results suggest that IUWLS
      offers an excellent alternative to PWL, while avoiding PWL-induced patient
      discomfort.
CI  - Copyright (c) 2017 The Authors. Published by Wolters Kluwer Health, Inc. All
      rights reserved.
FAU - Shin, Young Duck
AU  - Shin YD
AD  - Department of Anesthesiology.
FAU - Choi, Young Jin
AU  - Choi YJ
AD  - Department of Surgery, Chungbuk National University Hospital, Chungbuk National
      University College of Medicine, Cheongju, Republic of Korea.
FAU - Kim, Dae Hoon
AU  - Kim DH
AD  - Department of Surgery, Chungbuk National University Hospital, Chungbuk National
      University College of Medicine, Cheongju, Republic of Korea.
FAU - Park, Sung Su
AU  - Park SS
AD  - Department of Surgery, Chungbuk National University Hospital, Chungbuk National
      University College of Medicine, Cheongju, Republic of Korea.
FAU - Choi, Hanlim
AU  - Choi H
AD  - Department of Surgery, Chungbuk National University Hospital, Chungbuk National
      University College of Medicine, Cheongju, Republic of Korea.
FAU - Kim, Dong Ju
AU  - Kim DJ
AD  - Department of Surgery, Chungbuk National University Hospital, Chungbuk National
      University College of Medicine, Cheongju, Republic of Korea.
FAU - Park, Sungmin
AU  - Park S
AD  - Department of Surgery, Chungbuk National University Hospital, Chungbuk National
      University College of Medicine, Cheongju, Republic of Korea.
FAU - Yun, Hyo Yung
AU  - Yun HY
AD  - Department of Surgery, Chungbuk National University Hospital, Chungbuk National
      University College of Medicine, Cheongju, Republic of Korea.
FAU - Song, Young Jin
AU  - Song YJ
AD  - Department of Surgery, Chungbuk National University Hospital, Chungbuk National
      University College of Medicine, Cheongju, Republic of Korea.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Breast Neoplasms/*diagnostic imaging/*surgery
MH  - Female
MH  - Humans
MH  - Intraoperative Care
MH  - Margins of Excision
MH  - *Mastectomy, Segmental
MH  - Middle Aged
MH  - Preoperative Care
MH  - Reoperation
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Ultrasonography, Mammary/*methods
EDAT- 2018/02/03 06:00
MHDA- 2018/02/13 06:00
CRDT- 2018/02/03 06:00
PHST- 2018/02/03 06:00 [entrez]
PHST- 2018/02/03 06:00 [pubmed]
PHST- 2018/02/13 06:00 [medline]
AID - 10.1097/MD.0000000000009340 [doi]
AID - 00005792-201712150-00155 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Dec;96(50):e9340. doi: 10.1097/MD.0000000000009340.