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Radioactive Seed Localization Versus Wire-Guided Localization for Nonpalpable Breast Cancer: A Cost and Operating Room Efficiency Analysis

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

Abstract

Background

This study aimed to compare the cost and resource use between our first-year experience using breast-conserving surgery (BCS) with radioactive seed localization (RSL) and the previous-year standard practice of BCS with wire-guided localization (WGL) for patients with nonpalpable breast cancer at a large Canadian tertiary center.

Methods

For this retrospective cohort study, data for BCS cases with RSL was collected from 1 April 2015 to 31 March 2016 and for BCS cases with WGL from 1 April 2014 to 31 March 2015.

Results

The study compared 153 WGL patients with 194 RSL patients. The two groups had no significant demographic differences. The average cost per patient for RSL, including opportunity costs, was $250.90 versus $1130.41 for WGL. Dedicated allocated radiology appointments to RSL increased (9 per day), and fewer radiologists were required for these procedures per day. Patients were transported to the operating room more quickly for RSL procedures (120 vs. 254 min; p < 0.001). Fewer vasovagal reactions occurred after insertion of RSL versus WGL (p = 0.05). No significant differences were observed in terms of surgical time, specimen volume, positive margins, or margin reexcision rates. No significant differences in postoperative complication rates were observed.

Conclusions

In this study, RSL had lower costs than WGL, allowed for more efficient use of radiology scheduling and resources, and had shorter wait times for patients on their day of surgery. In addition, RSL led to fewer vasovagal reactions at insertion. Therefore, RSL should be used instead of WGL given the reduced cost, decreased need of human resources, improved efficiency, and potential benefits to the patient experience.

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Acknowledgment

The authors acknowledge Sasha Van Katwyk, a health economist at the Ottawa Hospital Research Institute, for his contributions to the cost comparison calculations.

DISCLOSURE

There are no conflicts of interest.

Author information

Authors and Affiliations

  1. Division of General Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada

    Yimeng Zhang MD, Erin Cordeiro MD, MSc, FRCSC, Angel Arnaout MD, MSc, FRCSC & Carolyn Nessim MD, MSc, FRCSC, FACS

  2. Department of Diagnostic Radiology, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada

    Jean Seely MD, FRCPC, Mukta Mahajan MD & Sue Domina MRT(R), BA

  3. Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada

    Joshua Hefler MD

  4. Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Canada

    Kednapa Thavorn PhD & Andrea Marie Ibrahim MSc

  5. School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada

    Kednapa Thavorn PhD

  6. Institute of Clinical and Evaluative Sciences (ICES@Ottawa), Toronto, Canada

    Kednapa Thavorn PhD

  7. Department of Radiation and Laser Safety, The Ottawa Hospital, Ottawa, ON, Canada

    Jon Aro BSc

  8. Department of Pathology and Laboratory Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada

    Denis Gravel MD, FRCPC

Authors
  1. Yimeng Zhang MD
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  2. Jean Seely MD, FRCPC
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  3. Erin Cordeiro MD, MSc, FRCSC
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  4. Joshua Hefler MD
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  5. Kednapa Thavorn PhD
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  6. Mukta Mahajan MD
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  7. Sue Domina MRT(R), BA
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  8. Jon Aro BSc
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  9. Andrea Marie Ibrahim MSc
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  10. Angel Arnaout MD, MSc, FRCSC
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  11. Denis Gravel MD, FRCPC
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  12. Carolyn Nessim MD, MSc, FRCSC, FACS
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Corresponding author

Correspondence to Carolyn Nessim MD, MSc, FRCSC, FACS.

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Zhang, Y., Seely, J., Cordeiro, E. et al. Radioactive Seed Localization Versus Wire-Guided Localization for Nonpalpable Breast Cancer: A Cost and Operating Room Efficiency Analysis. Ann Surg Oncol 24, 3567–3573 (2017). https://doi.org/10.1245/s10434-017-6084-z

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  • DOI: https://doi.org/10.1245/s10434-017-6084-z

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