Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander Universität Erlangen-Nürnberg, Erlangen, Germany;
Institute of Diagnostic Radiology, Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander Universität Erlangen-Nürnberg, Erlangen, Germany.
In Vivo. 2022 Sep-Oct;36(5):2342-2349. doi: 10.21873/invivo.12965.
BACKGROUND/AIM: Smaller, earlier-stage breast tumors are being found in breast cancer screening, and neoadjuvant chemotherapy is the gold standard when chemotherapy is indicated. Precise marking and localization of the tumor are thus becoming increasingly important. Wire-free localization techniques are under investigation in order to reduce presurgical radiography, pain, the risk of wire dislocation, and allow scheduling flexibility for patients and surgery departments.
This single-center observational study from June 2020 to October 2021 included 15 patients with mammographically or sonographically detected nonpalpable breast lesions. Radiofrequency identification (RFID) tags were placed preoperatively under ultrasound or radiologic guidance to localize lesions for planned surgery. All patients underwent breast conservation surgery, including one bilateral and one targeted axillary dissection.
Histology identified two benign and 13 malignant lesions, including three ductal carcinomas in situ and 11 invasive breast cancers. Placement, control radiography, and handling of the RFID tag were feasible in everyday routine for different radiologists and surgeons and managed cost-effectively. All of the RFID tags were found in the specimen radiographs.
The feasibility and cost-effectiveness of this non-wire localization method were demonstrated in this rather small cohort of patients. Further studies including larger numbers of patients are needed to confirm the method's accuracy.
背景/目的:在乳腺癌筛查中发现越来越多较小、早期的乳腺肿瘤,当需要化疗时,新辅助化疗是金标准。因此,肿瘤的精确标记和定位变得越来越重要。正在研究无导丝定位技术,以减少术前放射摄影、疼痛、导丝移位的风险,并为患者和手术部门提供灵活的预约安排。
这是一项 2020 年 6 月至 2021 年 10 月的单中心观察性研究,纳入了 15 名经乳房 X 线摄影或超声检查发现的不可触及乳腺病变患者。在术前超声或放射引导下放置射频识别(RFID)标签,以定位计划手术的病变。所有患者均接受保乳手术,包括双侧和单侧靶向腋窝清扫。
组织学发现了 2 个良性和 13 个恶性病变,包括 3 个导管原位癌和 11 个浸润性乳腺癌。不同的放射科医生和外科医生在日常工作中能够进行 RFID 标签的放置、控制放射摄影和处理,且具有成本效益。所有的 RFID 标签在标本放射照片中都能找到。
在这一小部分患者中,这种无导丝定位方法具有可行性和成本效益。需要进一步的研究包括更多数量的患者来证实该方法的准确性。