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10.1245/ASO.2003.03.050
Annals of Surgical Oncology 10:1039-1047 (2003)
© 2003 Society of Surgical Oncology
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ORIGINAL ARTICLES

Radioactive Seed Localization Breast Biopsy and Lumpectomy: Can Specimen Radiographs Be Eliminated?

Charles E. Cox, MD, Ben Furman, MD, Nicholas Stowell, Mark Ebert, John Clark, Elizabeth Dupont, MD, Alan Shons, MD, Claudia Berman, MD, John Beauchamp, MD, Mary Gardner, MD, Marla Hersch, MD, Priya Venugopal, MD, Margaret Szabunio, MD, Joanne Cressman, MD, Nils Diaz, MD, Vesna Vrcel, MD and Rita Fairclough, PA-C

From the Departments of Surgery (CEC, BF, NS, ME, JC, ED, AS), Radiology (CB, JB, MG, MH, PV, MS, JC), and Pathology (ND, VV, RF), Comprehensive Breast Cancer Program, H. Lee Moffitt Cancer Center and Research Institute at the University of South Florida, Tampa, Florida.

Correspondence: Address correspondence and reprint requests to: Charles E. Cox, MD, Breast Program, H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612; Fax: 813-979-9779; E-mail: coxce{at}moffitt.usf.edu

Background: Wire localization (WL) is the current standard for surgical diagnosis of nonpalpable breast lesions. Many disadvantages inherent to WL are solved with radioactive seed localization (RSL). This trial investigated the ability of RSL to reduce the need for specimen radiographs and operating room delays associated with WL.

Methods: A total of 134 women were entered onto an institutional review board–approved study. RSL was performed by placing a titanium seed containing .29 to 20 mCi of iodine-125 to within 1 cm of the suggestive breast lesion. The surgeon used a handheld gamma detector to locate and excise the iodine-125 seed and the lesion.

Results: Specimen radiographs were eliminated in 98 (79%) of 124 patients. Surgical seed retrieval was 100% in 124 patients. No seed migration occurred after correct radiographical placement. A total of 26 (21%) of 124 patients required a specimen radiograph; 22 (85%) of these 26 were performed for microcalcifications.

Conclusions: After surgical removal, RSL can eliminate specimen radiographs when the radiologist accurately places the seed and the pathologist grossly identifies the lesion. If small microcalcifications are noted before surgery, then specimen radiographs may be necessary. RSL reduced requirements for specimen radiographs, decreased OR time, improved incision placement, and improved resections to clear margins.

Key Words: Biopsy • Nonpalpable lesion • 125I radioactive seeds • Specimen radiograph




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 Ann. Surg. Oncol.Home page
C. E. Cox, B. Furman, E. L. Dupont, J. W. Jakub, N. Stowell, J. Clark, and M. Ebert
Novel Techniques in Sentinel Lymph Node Mapping and Localization of Nonpalpable Breast Lesions: The Moffitt Experience
Ann. Surg. Oncol., March 1, 2004; 11(3_suppl): 222S - 226S.
[Abstract] [Full Text] [PDF]


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