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Prospective randomized study comparing cryo-assisted and needle-wire localization of ultrasound-visible breast tumors.

Abstract：

BACKGROUND:This study compared the surgical results of 2 localization methods-cryo-assisted localization (CAL) and needle-wire localization (NWL)-in patients undergoing breast lumpectomy for breast cancer. METHODS:A total of 310 patients were treated in an institutional review board-approved study with 18 surgeons at 17 sites. Patients were randomized 2:1 to undergo either intraoperative CAL or NWL. A cryoprobe was inserted under ultrasound guidance in the operating room and an ice ball created an 8- to 10-mm margin around the lesion. The palpable ice ball then was dissected. NWL was placed according to institutional practice and resection was performed in a standard fashion. Surgical margins, complications, re-excisions, tissue volume, procedure times, ease of localization, specimen quality, and patient satisfaction were evaluated. Positive margins were defined as any type of disease present 1 mm or less from any specimen edge. RESULTS:Positive margin status did not differ between the 2 groups (28% vs. 31%). The volume of tissue removed was significantly less in the CAL group (49 vs. 66 mL, P = .002). Re-excisions were similar in both groups. CAL was superior in ease of lumpectomy, quality of specimen, acute surgical cosmesis, short-term cosmesis, patient satisfaction, and overall procedure time for the patient. CAL had a lower invasive positive margin rate (11% vs. 20%, P = .039) but a higher observed ductal carcinoma in situ-positive margin rate (30% vs. 18%, approaching statistical significance, P = .052). CONCLUSIONS:CAL is a preferred alternative to standard wire localization because it provides a palpable template, removes less tissue and improves cosmesis, decreases overall procedure time, and is more convenient for the patient and surgeon.

journal_name

Am J Surg

journal_title

American journal of surgery

authors

Tafra L,Fine R,Whitworth P,Berry M,Woods J,Ekbom G,Gass J,Beitsch P,Dodge D,Han L,Potruch T,Francescatti D,Oetting L,Smith JS,Snider H,Kleban D,Chagpar A,Akbari S

doi

10.1016/j.amjsurg.2006.06.012

subject

Has Abstract

pub_date

2006-10-01 00:00:00

pages

462-70

issue

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(06)00440-5

journal_volume

192

pub_type

杂志文章,随机对照试验

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Prospective randomized study comparing cryo-assisted and needle-wire localization of ultrasound-visible breast tumors.