Gray Richard J, Pockaj Barbara A, Karstaedt Patricia J, Roarke Michael C
Department of Surgery, Section of Surgical Oncology, Mayo Clinic, Scottsdale, AZ 85259, USA. gray.richard @mayo.edu
Am J Surg. 2004 Oct;188(4):377-80. doi: 10.1016/j.amjsurg.2004.06.023.
The current study sought to validate radioactive seed localization (RSL) as an alternative to wire localization (WL) to facilitate the operative excision of nonpalpable breast lesions.
One hundred consecutive patients underwent preoperative WL and the next 100 RSL. Margins were considered negative if > or =2 mm from in situ and invasive disease.
RSL resulted in 100% retrieval of the seeds and lesions. Sixty-eight percent of patients underwent RSL at least 1 day before surgery. RSL resulted in a 35% relative improvement in the rate of negative margins in the first specimen (P = 0.01) and a 62% relative improvement in the rate of reoperation for positive margins (P = 0.01). The sentinel lymph node (SLN) identification rate was 100% in both groups.
RSL is effective and safe, and this procedure significantly improved the rate of negative margins in the first specimen and the rate of reoperation for positive margins compared to WL. We highly favor RSL over WL.
本研究旨在验证放射性种子定位(RSL)作为金属丝定位(WL)的替代方法,以促进不可触及乳腺病变的手术切除。
连续100例患者接受术前WL,随后的100例接受RSL。如果距原位癌和浸润性癌边缘≥2mm,则认为切缘阴性。
RSL使种子和病变的取出率达到100%。68%的患者在手术前至少1天接受了RSL。RSL使第一个标本的阴性切缘率相对提高了35%(P = 0.01),使切缘阳性再次手术率相对提高了62%(P = 0.01)。两组前哨淋巴结(SLN)识别率均为100%。
RSL有效且安全,与WL相比,该方法显著提高了第一个标本的阴性切缘率和切缘阳性再次手术率。我们强烈推荐RSL而非WL。