A cosmesis outcome substudy in a prospective, randomized trial comparing radioguided seed localization with standard wire localization for nonpalpable, invasive, and in situ breast carcinomas

Elena Parvez; Sylvie D Cornacchi; Nicole Hodgson; Achilleas Thoma; Iwa Kong; Gary Foster; Ji Cheng; Charlie H Goldsmith; Dyda Dao; Peter J Lovrics

doi:10.1016/j.amjsurg.2014.05.030

A cosmesis outcome substudy in a prospective, randomized trial comparing radioguided seed localization with standard wire localization for nonpalpable, invasive, and in situ breast carcinomas

Am J Surg. 2014 Nov;208(5):711-718. doi: 10.1016/j.amjsurg.2014.05.030. Epub 2014 Aug 5.

Authors

Affiliations

¹ Department of Surgery, McMaster University, Hamilton, ON, Canada.
² Department of Surgery, McMaster University, Hamilton, ON, Canada; Department of Surgical Oncology, Hamilton Health Sciences and Juravinski Hospital and Cancer Centre, Hamilton, ON, Canada; Department of Oncology, Hamilton Health Sciences and Juravinski Hospital and Cancer Centre, Hamilton, ON, Canada.
³ Department of Surgery, McMaster University, Hamilton, ON, Canada; Department of Surgery, St. Joseph's Healthcare, Hamilton, ON, Canada.
⁴ Department of Oncology, Hamilton Health Sciences and Juravinski Hospital and Cancer Centre, Hamilton, ON, Canada.
⁵ Department of Clinical Epidemiology and Biostatistics, McMaster University and Biostatistics Unit, St. Joseph's Healthcare, Hamilton, ON, Canada.
⁶ Department of Surgery, McMaster University, Hamilton, ON, Canada; Department of Clinical Epidemiology and Biostatistics, McMaster University and Biostatistics Unit, St. Joseph's Healthcare, Hamilton, ON, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
⁷ Department of Surgery, McMaster University, Hamilton, ON, Canada; Department of Surgical Oncology, Hamilton Health Sciences and Juravinski Hospital and Cancer Centre, Hamilton, ON, Canada; Department of Oncology, Hamilton Health Sciences and Juravinski Hospital and Cancer Centre, Hamilton, ON, Canada; Department of Surgery, St. Joseph's Healthcare, Hamilton, ON, Canada. Electronic address: lovricsp@mcmaster.ca.

PMID: 25201587
DOI: 10.1016/j.amjsurg.2014.05.030

Abstract

Background: The primary study objective was to compare the cosmetic result of radioguided seed localization (RSL) with wire localization (WL).

Methods: A subgroup of patients enrolled in a multicentered, randomized trial comparing WL with RSL participated. Frontal photographs were taken 1 and 3 years postsurgery. The European Organization for Research and Treatment of Cancer Cosmetic Rating System was used to evaluate cosmesis outcomes by the patient and a panel of 5 raters.

Results: The study enrolled 73 patients (WL, n = 38; RSL, n = 35). Most patients rated their overall cosmesis as "excellent" or "good" (76% WL, 80% RSL). Patient and panel ratings on all cosmetic outcomes were similar between groups. Multivariable regression for overall cosmesis found larger specimen volume and reoperation to be predictors of worse ratings.

Conclusions: All cosmetic outcomes assessed were similar after WL and RSL. The comparable outcomes may reflect similar reoperation rates and volumes of excision between groups.

Keywords: Breast conserving surgery; Breast shape; Cosmetic outcome; Needle localization; Patient ratings.

Publication types

Comparative Study
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Breast Neoplasms / diagnostic imaging
Breast Neoplasms / surgery*
Carcinoma, Ductal, Breast / diagnostic imaging
Carcinoma, Ductal, Breast / surgery*
Carcinoma, Intraductal, Noninfiltrating / diagnostic imaging
Carcinoma, Intraductal, Noninfiltrating / surgery*
Esthetics*
Female
Follow-Up Studies
Humans
Iodine Radioisotopes / administration & dosage
Mastectomy, Segmental / instrumentation
Mastectomy, Segmental / methods*
Middle Aged
Prospective Studies
Radionuclide Imaging
Radiopharmaceuticals* / administration & dosage
Treatment Outcome

Substances

Iodine Radioisotopes
Radiopharmaceuticals