125I radioactive seed localization for non-palpable lesions in breast cancer

Abstract

Aim: Marking of non-palpable breast lesions with ¹²⁵I radioactive seeds is an alternative to the use of the surgical wire. The objective of this work is to present the results that we have obtained using radioactive seed localization compared to the reference technique in our center, the wire localization of non-palpable breast lesions.

Material and method: Longitudinal prospective study that includes patients with histological diagnostic of breast cancer, with non-palpable lesions that are candidates to primary surgical treatment by radioactive seed localization (2016-2018) and by wire localization (2015-2016). Histological analysis of the surgical specimen was performed determining the status of surgical margins. The volume of the surgical specimen was calculated.

Results: A total of 146 patients were included, 95 who underwent surgery by radioactive seed localization and 51 by wire localization. The mean cube volume of the specimens were 135.67cm3 vs. 190.77cm3 (p=0.017), respectively. Eleven patients who underwent surgery by radioactive seed localization showed affected margins of the specimen (11.6%), versus 7 (13.2%) of wire localization group (p=0.084). Reintervention was performed in 9 of the patients marked with seeds and in 7 marked with wires (p=0.49).

Conclusion: The use of ¹²⁵I radioactive seeds is feasible in non-palpable breast lesions, with a low rate of reintervention and volumes of surgical specimens significantly lower than those obtained by wire localization.

Keywords: Arpón quirúrgico; Breast-conserving surgery; Cirugía conservadora de la mama; Cirugía radioguiada; Lesiones no palpables de mama; Non-palpable breast lesion; Radioactive seed localization; Radioguided surgery; Semillas radiactivas; Wire localization.