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Guiding Breast-Conserving Surgery in Patients After Neoadjuvant Systemic Therapy for Breast Cancer: A Comparison of Radioactive Seed Localization with the ROLL Technique

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Radioguided occult lesion localization (ROLL) with technetium-99 m colloid (ROLL-99mTc) is commonly used to perform breast-conserving surgery in patients with nonpalpable breast tumors. Radioactive seed localization is a relatively new technique that localizes the tumor with a radioactive iodine-125 (125I) seed. The feasibility and outcome of these techniques after neoadjuvant systemic treatment has not been widely investigated.

Methods

All patients treated with neoadjuvant systemic treatment between 2007 and 2010 in the Netherlands Cancer Institute who underwent breast-conserving surgery with the ROLL-99mTc technique (n = 83) or with 125I seed localization (n = 71) were analyzed. The weight of the resected specimen, the margins, and the percentage of patients requiring a second surgical intervention as a result of positive margins were assessed.

Results

Patient and tumor characteristics and systemic treatment regimens were comparable between both groups. The median weight of the resected specimen (53 vs. 48 g), the median smallest margin (3.5 vs. 3.0 mm), and the risk for additional surgery for incomplete resections (7 vs. 8 %) did not differ significantly between patients treated with the ROLL-99mTc technique and 125I seed localization.

Conclusions

The ROLL-99mTc technique and 125I seed localization demonstrate comparable results when used to perform breast-conserving surgery after neoadjuvant systemic treatment. Because 125I seed localization does not require additional radiological localization shortly before surgery, it simplifies surgery scheduling. Therefore, we prefer 125I seed localization to perform breast-conserving surgery after neoadjuvant systemic treatment.

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Acknowledgment

The authors thank Nicola Russell for her critical review.

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Authors and Affiliations

  1. Department of Surgical Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands

    Mila Donker MD, Caroline A. Drukker MD, Emiel J. Th. Rutgers MD, PhD & Marie-Jeanne T. F. D. Vrancken Peeters MD, PhD

  2. Department of Nuclear Medicine, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands

    Renato A. Valdés Olmos MD, PhD

  3. Department of Radiology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands

    Claudette E. Loo MD

  4. Department of Medical Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands

    Gabe S. Sonke MD, PhD

  5. Department of Pathology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands

    Jelle Wesseling MD, PhD

  6. Department of Radiation Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands

    Tanja Alderliesten PhD

Authors
  1. Mila Donker MD
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  2. Caroline A. Drukker MD
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  3. Renato A. Valdés Olmos MD, PhD
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  4. Emiel J. Th. Rutgers MD, PhD
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  5. Claudette E. Loo MD
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  6. Gabe S. Sonke MD, PhD
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  7. Jelle Wesseling MD, PhD
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  8. Tanja Alderliesten PhD
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  9. Marie-Jeanne T. F. D. Vrancken Peeters MD, PhD
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Corresponding author

Correspondence to Marie-Jeanne T. F. D. Vrancken Peeters MD, PhD.

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Donker, M., Drukker, C.A., Valdés Olmos, R.A. et al. Guiding Breast-Conserving Surgery in Patients After Neoadjuvant Systemic Therapy for Breast Cancer: A Comparison of Radioactive Seed Localization with the ROLL Technique. Ann Surg Oncol 20, 2569–2575 (2013). https://doi.org/10.1245/s10434-013-2921-x

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  • DOI: https://doi.org/10.1245/s10434-013-2921-x

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