This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Rahusen, F. D. Articles by Meijer, S. Search for Related Content PubMed PubMed Citation Articles by Rahusen, F. D. Articles by Meijer, S. Related Collections Diagnosis Surgery

Ultrasound-Guided Lumpectomy of Nonpalpable Breast Cancer Versus Wire-Guided Resection: A Randomized Clinical Trial

From the Department of Surgery (FDR), Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands; Departments of Surgical Oncology (AJAB, HFJF, SM) and Radiology (AHMTvA), Vrije Universiteit Medical Center, Amsterdam, The Netherlands; and Department of Surgery (RPAB), District General Hospital, Amstelveen, The Netherlands.

Correspondence: Address correspondence and reprint requests to: S. Meijer, MD, PhD, VU Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam; Fax: 31-2-4444512; E-mail: s.meijer{at}vumc.nl

Background: The wire-guided excision of nonpalpable breast cancer often results in tumor resections with inadequate margins. This prospective, randomized trial was undertaken to investigate whether intraoperative ultrasound (US) guidance enables a better margin clearance than the wire-guided technique in the breast-conserving treatment of nonpalpable breast cancers.

Methods: Patients with a preoperative histological diagnosis of nonpalpable breast cancer that could be visualized both with US and mammography were included. Patients were randomized to undergo either a wire-guided or a US-guided excision. Adequate margins were defined as 1 mm.

Results: Of 49 included patients, 23 were assigned to undergo wire-guided excision and 26 to undergo US-guided excision. One patient crossed over to US-guided excision after inadvertent wire displacement. Mean tumor diameter, specimen weight, and operating time were similar in both groups. The excision was adequate in 24 (89%) of 27 US-guided excisions and 12 (55%) of 22 wire-guide excisions (P = .007).

Conclusions: US-guided excision seems to be superior to wire-guided excision with respect to margin clearance of mammographically detected and US-visible nonpalpable breast cancers. Patients do not have to undergo the unpleasant wire placement before surgery.

Key Words: Nonpalpable • Mammography • Ultrasonography • Breast neoplasms • Segmental mastectomy • Needle biopsy

This article has been cited by other articles:

				L. E. McCahill, A. Privette, T. James, J. Sheehey-Jones, J. Ratliff, D. Majercik, D. N. Krag, M. Stanley, and S. Harlow Quality Measures for Breast Cancer Surgery: Initial Validation of Feasibility and Assessment of Variation Among Surgeons Arch Surg, May 1, 2009; 144(5): 455 - 462. [Abstract] [Full Text] [PDF]

				A. Haid, M. Knauer, S. Dunzinger, Z. Jasarevic, R. Koberle-Wuhrer, A. Schuster, M. Toeppker, B. Haid, E. Wenzl, and F. Offner Intra-operative Sonography: A Valuable Aid During Breast-Conserving Surgery for Occult Breast Cancer Ann. Surg. Oncol., November 1, 2007; 14(11): 3090 - 3101. [Abstract] [Full Text] [PDF]

				C. J. C. Cash, C. E. Coles, G. M. Treece, A. D. Purushotham, P. Britton, R. Sinnatamby, A. H. Gee, and R. W. Prager Breast Cancers: Noninvasive Method of Preoperative Localization with Three-dimensional US and Surface Contour Mapping Radiology, November 1, 2007; 245(2): 556 - 566. [Abstract] [Full Text] [PDF]

				C. Ngo, A. G. Pollet, J. Laperrelle, G. Ackerman, S. Gomme, F. Thibault, V. Fourchotte, and R. J. Salmon Intraoperative ultrasound localization of nonpalpable breast cancers. Ann. Surg. Oncol., September 1, 2007; 14(9): 2485 - 2489. [Abstract] [Full Text] [PDF]

				R. L. Rahman, S. Crawford, A. Larkin, and R. Quinlan Superiority of Sonographic Hematoma Guided Resection of Mammogram Only Visible Breast Cancer: Wire Localization Should be an Exception Not the Rule Ann. Surg. Oncol., August 1, 2007; 14(8): 2228 - 2232. [Abstract] [Full Text] [PDF]

				R. Layeequr Rahman, E. Iuanow, S. Crawford, and R. Quinlan Sonographic Hematoma-Guided vs Wire-Localized Lumpectomy for Breast Cancer: A Comparison of Margins and Volume of Resection Arch Surg, April 1, 2007; 142(4): 343 - 346. [Abstract] [Full Text] [PDF]

				L. Tafra, S. J. Smith, J. E. Woodward, K. L. Fernandez, K. T. Sawyer, and R. T. Grenko Pilot Trial of Cryoprobe-Assisted Breast-Conserving Surgery for Small Ultrasound-Visible Cancers Ann. Surg. Oncol., November 1, 2003; 10(9): 1018 - 1024. [Abstract] [Full Text] [PDF]