Radio-guided vs clip-guided localization of nonpalpable mass-like lesions of the breast from a screened population: A propensity score-matched study

Fabio Corsi, Daniela Bossi, Francesca Combi, Ourania Papadopoulou, Rosella Amadori, Lea Regolo, Giuseppe Trifirò, Sara Albasini, Serena Mazzucchelli, Luca Sorrentino

Research output: Contribution to journalReview article

Abstract

Background and Objectives: An accurate localization is mandatory to tailor breast lumpectomy in nonpalpable cancers. The aim of this study was to compare radio-guided localization (ROLL) vs ultrasound localization of a titanium clip with collagen (TCC) in nonpalpable mass-like breast cancers. Methods: Two hundred seventy-three consecutive patients were reviewed: 64 patients were localized by TCC and 209 patients by ROLL. Propensity score-matched analysis was performed. Margin status and reintervention rates were compared. Adequacy of resection was expressed as the calculated resection ratio (CRR) considering lesion size. Loco-regional and distant recurrence rates were assessed with ROLL vs TCC. Results: No differences were found with ROLL vs TCC in clear margins (90.6% vs 89.1%; odds ratio, 0.74; P = 0.64) or reoperations (6.7% vs 1.6%; P = 0.529). ROLL allowed more tailored resections compared with TCC (adjusted CRR, 1.7 vs 2.7; P = 0.0008), particularly in lesions with associated extensive intraductal component (CRR, 3.0 vs 4.5; P = 0.017). Loco-regional recurrence occurred in 1.9% of ROLL patients vs 3.2% of TCC cases (P = 0.628). Conclusions: ROLL and TCC are equally effective to excise nonpalpable mass-like breast cancers with clear margins, providing similar loco-regional control. However, ROLL allows more tailored breast resections, particularly in lesions with the associated extensive intraductal component.

Original languageEnglish
JournalJournal of Surgical Oncology
DOIs
Publication statusPublished - Jan 1 2019

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Propensity Score
Radio
Surgical Instruments
Titanium
Breast
Collagen
Population
Breast Neoplasms
Recurrence
Segmental Mastectomy
Reoperation
Odds Ratio

Keywords

  • breast cancer
  • breast-conserving surgery
  • clip
  • nonpalpable breast lesions
  • radio-guided occult lesion localization

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Radio-guided vs clip-guided localization of nonpalpable mass-like lesions of the breast from a screened population : A propensity score-matched study. / Corsi, Fabio; Bossi, Daniela; Combi, Francesca; Papadopoulou, Ourania; Amadori, Rosella; Regolo, Lea; Trifirò, Giuseppe; Albasini, Sara; Mazzucchelli, Serena; Sorrentino, Luca.

In: Journal of Surgical Oncology, 01.01.2019.

Research output: Contribution to journalReview article

Corsi, Fabio ; Bossi, Daniela ; Combi, Francesca ; Papadopoulou, Ourania ; Amadori, Rosella ; Regolo, Lea ; Trifirò, Giuseppe ; Albasini, Sara ; Mazzucchelli, Serena ; Sorrentino, Luca. / Radio-guided vs clip-guided localization of nonpalpable mass-like lesions of the breast from a screened population : A propensity score-matched study. In: Journal of Surgical Oncology. 2019.
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title = "Radio-guided vs clip-guided localization of nonpalpable mass-like lesions of the breast from a screened population: A propensity score-matched study",
abstract = "Background and Objectives: An accurate localization is mandatory to tailor breast lumpectomy in nonpalpable cancers. The aim of this study was to compare radio-guided localization (ROLL) vs ultrasound localization of a titanium clip with collagen (TCC) in nonpalpable mass-like breast cancers. Methods: Two hundred seventy-three consecutive patients were reviewed: 64 patients were localized by TCC and 209 patients by ROLL. Propensity score-matched analysis was performed. Margin status and reintervention rates were compared. Adequacy of resection was expressed as the calculated resection ratio (CRR) considering lesion size. Loco-regional and distant recurrence rates were assessed with ROLL vs TCC. Results: No differences were found with ROLL vs TCC in clear margins (90.6{\%} vs 89.1{\%}; odds ratio, 0.74; P = 0.64) or reoperations (6.7{\%} vs 1.6{\%}; P = 0.529). ROLL allowed more tailored resections compared with TCC (adjusted CRR, 1.7 vs 2.7; P = 0.0008), particularly in lesions with associated extensive intraductal component (CRR, 3.0 vs 4.5; P = 0.017). Loco-regional recurrence occurred in 1.9{\%} of ROLL patients vs 3.2{\%} of TCC cases (P = 0.628). Conclusions: ROLL and TCC are equally effective to excise nonpalpable mass-like breast cancers with clear margins, providing similar loco-regional control. However, ROLL allows more tailored breast resections, particularly in lesions with the associated extensive intraductal component.",
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T1 - Radio-guided vs clip-guided localization of nonpalpable mass-like lesions of the breast from a screened population

T2 - A propensity score-matched study

AU - Corsi, Fabio

AU - Bossi, Daniela

AU - Combi, Francesca

AU - Papadopoulou, Ourania

AU - Amadori, Rosella

AU - Regolo, Lea

AU - Trifirò, Giuseppe

AU - Albasini, Sara

AU - Mazzucchelli, Serena

AU - Sorrentino, Luca

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background and Objectives: An accurate localization is mandatory to tailor breast lumpectomy in nonpalpable cancers. The aim of this study was to compare radio-guided localization (ROLL) vs ultrasound localization of a titanium clip with collagen (TCC) in nonpalpable mass-like breast cancers. Methods: Two hundred seventy-three consecutive patients were reviewed: 64 patients were localized by TCC and 209 patients by ROLL. Propensity score-matched analysis was performed. Margin status and reintervention rates were compared. Adequacy of resection was expressed as the calculated resection ratio (CRR) considering lesion size. Loco-regional and distant recurrence rates were assessed with ROLL vs TCC. Results: No differences were found with ROLL vs TCC in clear margins (90.6% vs 89.1%; odds ratio, 0.74; P = 0.64) or reoperations (6.7% vs 1.6%; P = 0.529). ROLL allowed more tailored resections compared with TCC (adjusted CRR, 1.7 vs 2.7; P = 0.0008), particularly in lesions with associated extensive intraductal component (CRR, 3.0 vs 4.5; P = 0.017). Loco-regional recurrence occurred in 1.9% of ROLL patients vs 3.2% of TCC cases (P = 0.628). Conclusions: ROLL and TCC are equally effective to excise nonpalpable mass-like breast cancers with clear margins, providing similar loco-regional control. However, ROLL allows more tailored breast resections, particularly in lesions with the associated extensive intraductal component.

AB - Background and Objectives: An accurate localization is mandatory to tailor breast lumpectomy in nonpalpable cancers. The aim of this study was to compare radio-guided localization (ROLL) vs ultrasound localization of a titanium clip with collagen (TCC) in nonpalpable mass-like breast cancers. Methods: Two hundred seventy-three consecutive patients were reviewed: 64 patients were localized by TCC and 209 patients by ROLL. Propensity score-matched analysis was performed. Margin status and reintervention rates were compared. Adequacy of resection was expressed as the calculated resection ratio (CRR) considering lesion size. Loco-regional and distant recurrence rates were assessed with ROLL vs TCC. Results: No differences were found with ROLL vs TCC in clear margins (90.6% vs 89.1%; odds ratio, 0.74; P = 0.64) or reoperations (6.7% vs 1.6%; P = 0.529). ROLL allowed more tailored resections compared with TCC (adjusted CRR, 1.7 vs 2.7; P = 0.0008), particularly in lesions with associated extensive intraductal component (CRR, 3.0 vs 4.5; P = 0.017). Loco-regional recurrence occurred in 1.9% of ROLL patients vs 3.2% of TCC cases (P = 0.628). Conclusions: ROLL and TCC are equally effective to excise nonpalpable mass-like breast cancers with clear margins, providing similar loco-regional control. However, ROLL allows more tailored breast resections, particularly in lesions with the associated extensive intraductal component.

KW - breast cancer

KW - breast-conserving surgery

KW - clip

KW - nonpalpable breast lesions

KW - radio-guided occult lesion localization

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DO - 10.1002/jso.25409

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