Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

One-third of breast cancers present as non-palpable lesions. The current gold standard treatment for these cancers is localized wide local excision using wire-guided localization (WGL). WGL has drawbacks including technical and scheduling issues resulting in the development of alternative radioguided techniques (RGL). A systematic review was performed to identify studies comparing RGL and WGL. The outcomes of surgical margin status, re-operation rates, surgical operative time, volume and excised specimen weight and successful sentinel lymph node biopsy (SLNB) rates were evaluated. Pooled odds ratios (ORs) and 95 % confidence intervals were estimated using fixed-effects analyses and random-effects analyses in case of statistically significant heterogeneity (p < 0.05). Seven randomized controlled trials (RCTs) matching the inclusion criteria were identified. The pooled ORs for involved surgical margin status were 0.78 (95 % CI, 0.52-1.17); for re-operations 0.74 (95 % CI, 0.49-1.11) and for successful SLNB 1.29 (95 % CI, 0.66-2.53). There was a significant difference in surgical operating time in favour of RGL (mean difference (MD), -2.95; 95 % CI, -4.43, -1.47) and a significant difference in excised specimen volume, favouring WGL (MD, 6.79; 95 % CI, 0.03, 13.56). The MD for a specimen weight of -3.00 (95 % CI, -15.15, 9.15) showed no significant difference between RGL and WGL. RGL has a reduced operating time, but larger volume excisions compared to WGL. There is insufficient evidence to support the uptake of RGL over WGL, and larger, adequately powered, multi-centre RCTs are required.

Original publication

DOI

10.1007/s10549-013-2547-5

Type

Journal article

Journal

Breast Cancer Res Treat

Publication Date

07/2013

Volume

140

Pages

241 - 252

Keywords

Breast Neoplasms, Female, Humans, Mastectomy, Segmental, Palpation, Randomized Controlled Trials as Topic, Reoperation, Sentinel Lymph Node Biopsy, Treatment Outcome