Skip to main content

Advertisement

SpringerLink
Log in

Use of Hydrogel Breast Biopsy Tissue Markers Reduces the Need for Wire Localization

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

Abstract

Background

The purpose of this study was to determine whether breast biopsy tissue markers composed of an ultrasound-visible hydrogel reduced the need for preoperative wire localization (WL) in patients undergoing a partial mastectomy.

Methods

A single-surgeon, single-institution, retrospective chart review was performed on 691 consecutive female patients, with mean age 67 years (range 36–98 years), from 2009 to 2012 undergoing partial mastectomies after percutaneous biopsies by stereotactic or ultrasound guidance.

Results

Overall, the use of WL was more frequent in patients who had standard (other) markers placed during biopsy as opposed to those with hydrogel markers (HydroMARK). For stereotactic biopsy, 75.8 % of patients with a standard marker required WL versus 17.1 % with HydroMARK and for ultrasound biopsy, 22.6 % standard versus 4.3 % HydroMARK (p < .0001, p < .0001). In some cases where hydrogel markers were used, WL was used for “bracketing” because of the presence of microcalcifications. In cases where standard markers were used, WL was not used because of either IOUS visibility of residual lesion or marker visibility. Specimen volume and re-excision rate were comparable between patients with hydrogel and standard markers, showing no significant differences (p = .1673, p = .1813 respectively).

Conclusions

Hydrogel biopsy tissue markers optimize the surgeon’s ability to perform a partial mastectomy without the use of WL. HydroMARK was as effective as a standard marker in terms of partial mastectomy specimen volume and re-excision rate. This yields potential for cost savings, increased efficacy in operating room and radiology scheduling, and patient comfort and convenience.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Postma EL, Verkooijen HM, Van Esser S, Hobbelink MG, van der Schelling GP, Koelemij R, et al. Efficacy of “radioguided occult lesion localization” (ROLL) versus “wire-guided localization” (WGL) in breast conserving surgery for non-palpable breast cancer: a randomized controlled multicentre trial. Breast Cancer Res Treat. 2012;136:469–78.

    Article  PubMed  CAS  Google Scholar 

  2. Chen SC, Yang HR, Hwang TL, Chen MF, Cheung YC, Hsueh S. Intraoperative ultrasonographically guided excisional biopsy or vacuum-assisted core needle biopsy for nonpalpable breast lesions. Ann Surg. 2003;238:738–42.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Donker M, Drukker CA, Valdes Olmos RA, Rutgers EJ, Loo CE, Sonke GS, 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. 2013;20:2569–75.

  4. Ahmed M, Hemelrijck MV, Douek M. Systematic review of radioguided versus wire-guided localization in the treatment of non-palpable breast cancers. Breast Cancer Res Treat. 2013;140:241–52.

    Article  PubMed  CAS  Google Scholar 

  5. Ahmed M, Douek M. ROLL versus RSL: toss of a coin? Breast Cancer Res Treat. 2013;140:213–7.

    Article  PubMed  CAS  Google Scholar 

  6. Alderliesten T, Loo CE, Pengel KE, Rutgers EJ, Gilhuijs KG, Vrancken Peeters MJ. Radioactive seed localization of breast lesions: an adequate localization method without seed migration. Breast J. 2011;17:594–601.

    Article  PubMed  Google Scholar 

  7. MariscalMartinez A, Sola M, Perez de Tudela AP, Julian JF, Fraile M, Vizcaya S, et al. Radioguided localization of non-palpable breast cancer lesions: randomized comparison with wire localization in patients undergoing conservative surgery and sentinel node biopsy. AJR Am J Roentgenol. 2009;193:1001–9.

    Article  PubMed  Google Scholar 

  8. Thompson M, Henry-Tillman R, Margulies A, Thostenson J, Bryant-Smith G, Fincher R, et al. Hematoma-directed ultrasound-guided (HUG) breast lumpectomy. Ann Surg Oncol. 2007;14:148–56.

    Article  PubMed  Google Scholar 

  9. Cox CE, Furman B, Stowell N, Ebert M, Clark J, Dupont E, et al. Radioactive seed localization breast biopsy and lumpectomy: can specimen radiographs be eliminated? Ann Surg Oncol. 2003;10:1039–47.

    Article  PubMed  Google Scholar 

  10. Jakub JW, Gray RJ, Degnim AC, Boughey JC, Gardner M, Cox CE, et al. Current status of radioactive seed for localization of non palpable breast lesions. Am J Surg. 2010;199:522–8.

    Article  PubMed  Google Scholar 

  11. Margolin FR, Kaufman L, Denny SR, Jacobs RP, Schrumpf JD. Metallic marker placement after stereotactic core biopsy of breast calcifications: comparison of two clips and deployment techniques. AJR Am J Roentgenol. 2003;181:1685–90.

    Article  PubMed  Google Scholar 

  12. Murphy JO, Moo TA, King TA, Van Zee KJ, Villegas KA, Stempel M, et al. Radioactive seed localization compared to wire localization in breast-conserving surgery: initial 6-month experience. Ann Surg Oncol. 2013;20:4121–7.

    Article  PubMed  Google Scholar 

  13. Boughey JC, Peintinger F, Meric-Bernstam F, Perry AC, Hunt KK, Babiera GV, et al. Impact of preoperative versus postoperative chemotherapy on the extent and number of surgical procedures in patients treated in randomized clinical trials for breast cancer. Ann Surg. 2006;244:464–70.

    PubMed  PubMed Central  Google Scholar 

  14. Mook J, Klein R, Kobbermann A, Unzeitig A, Euhus D, Peng Y, et al. Volume of excision and cosmesis with routine cavity shave margins technique. Ann Surg Oncol. 2012;19:886–91.

    Article  PubMed  Google Scholar 

  15. Van Riet YEA, Maaskant AJG, Creemers GJ, van Warmerdam LJ, Jansen FH, van de Velde CJ, et al. Identification of residual breast tumour localization after neo-adjuvant chemotherapy using a radioactive 125 iodine seed. Eur J Surg Oncol. 2010;36:164–9.

    Article  PubMed  Google Scholar 

  16. Van Riet YEA, Jansen FH, Van Beek M, van de Velde CJ, Rutten HJ, Nieuwenhuijzen GA. Localization of non-palpable breast cancer using a radiolabelled titanium seed. Br J Surg. 2010;97:1240–5.

    Article  PubMed  Google Scholar 

  17. Schnabel F, Boolbol SK, Gittleman M, Karni T, Tafra L, Feldman S, et al. A randomized prospective study of lumpectomy margin assessment with use of MarginProbe in patients with nonpalpable breast malignancies. Ann Surg Oncol. 2014;21:1589–95. doi:10.1245/s10434-014-3602-0.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Barentsz MW, Van Dalen T, Gobardhan PD, Bongers V, Perre CI, Pijnappel RM, et al. Intraoperative ultrasound guidance for excision of non-palpable invasive breast cancer: a hospital-based series and an overview of the literature. Breast Cancer Res Treat. 2012;135:209–19.

    Article  PubMed  CAS  Google Scholar 

  19. McGhan LJ, McKeever SC, Pockaj BA, Wasif N, Giurescu ME, Walton HA, et al. Radioactive seed localization for nonpalpable breast lesions: review of 1,000 consecutive procedures at a single institution. Ann Surg Oncol. 2011;18:3096–101.

    Article  PubMed  Google Scholar 

  20. Klein RL, Mook JA, Euhus DM, Rao R, Wynn RT, Eastman AB, et al. Evaluation of a hydrogel based breast biopsy marker (HydroMARK) as an alternative to wire and radioactive seed localization for non-palpable breast lesions. J Surg Oncol. 2012;105:591–4.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgment

This study was presented in part as a poster at the American Society of Breast Surgeons 15th Annual Meeting, Las Vegas, NV, April 30 to May 4, 2014.

Author information

Authors and Affiliations

  1. Comprehensive Breast Care Center of Tampa Bay, Morton Plant Hospital, Clearwater, FL, USA

    Peter W. Blumencranz MD, FACS

  2. Oncology Research Department, Morton Plant Hospital, Clearwater, FL, USA

    Debra Ellis RN, CCRP & Kylee Barlowe BS, CCRP

Authors
  1. Peter W. Blumencranz MD, FACS
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Debra Ellis RN, CCRP
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kylee Barlowe BS, CCRP
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Peter W. Blumencranz MD, FACS.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Blumencranz, P.W., Ellis, D. & Barlowe, K. Use of Hydrogel Breast Biopsy Tissue Markers Reduces the Need for Wire Localization. Ann Surg Oncol 21, 3273–3277 (2014). https://doi.org/10.1245/s10434-014-3917-x

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-014-3917-x

Keywords

Search

Navigation