Newman Ashley M, Daly Abigail E, Anderman Kyle J, Dang Pragya A, Nguyen Anvy T, Smith Barbara L, Gadd Michele A, Specht Michelle C
Breast Surgery Section, Division of GI and Oncologic Surgery, Massachusetts General Hospital, 55 Fruit St, Yawkey 7B, Boston, MA, 02114, USA.
Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.
Breast Cancer Res Treat. 2025 Jun;211(3):669-674. doi: 10.1007/s10549-025-07681-y. Epub 2025 Mar 27.
Radiofrequency identification tag localization (TL) is a method of localizing nonpalpable breast cancers and high-risk lesions that can be performed prior to the day of surgery (DOS). We evaluated if placement of TL prior to DOS would affect patients' length of stay (LOS) and improve surgical on-time starts.
A retrospective review of excisional biopsies and lumpectomies with TL was performed. Associations between timing of TL (DOS vs. prior), time in radiology, surgical case delay, LOS on DOS, and total LOS were assessed.
439 patients underwent TL for nonpalpable breast cancer or high-risk lesions between July 2018 and July 2021 at our institutions. 158 TL procedures were performed on the DOS and 281 TL procedures were performed a median of 3 days prior to the DOS (range 1-28). All intended targets were removed. The median total LOS (time in radiology and surgery) was 336 min and 434 min for the early placement group and DOS group, respectively (p < 0.001). The median length of time in radiology was 47 min for the early placement group and 54 min for the DOS group (p < 0.001). Cases were significantly more likely to be delayed (p = 0.002) and could not be first-start cases if TL was performed on DOS. Vasovagal events during TL and narcotic use in the post-operative setting were rare across both groups.
TL prior to DOS was associated with a decrease in total LOS (p < 0.001) and case delay (p = 0.002), as well as an increase in first-start cases. These findings suggest the potential superiority of TL prior to DOS.
射频识别标签定位（TL）是一种在手术日（DOS）之前对不可触及的乳腺癌和高危病变进行定位的方法。我们评估了在手术日之前进行TL定位是否会影响患者的住院时间（LOS）并提高手术按时开始率。
对采用TL定位的切除活检和乳房肿块切除术进行回顾性研究。评估TL定位时间（手术日当天与之前）、在放射科的时间、手术病例延迟、手术日当天的住院时间以及总住院时间之间的关联。
2018年7月至2021年7月期间，我们机构有439例患者因不可触及的乳腺癌或高危病变接受了TL定位。158例TL定位操作在手术日当天进行，281例TL定位操作在手术日之前的中位时间为3天（范围1 - 28天）进行。所有预定目标均被切除。早期定位组和手术日当天组的中位总住院时间（在放射科和手术的时间）分别为336分钟和434分钟（p < 0.001）。早期定位组在放射科的中位时间为47分钟，手术日当天组为54分钟（p < 0.001）。如果在手术日当天进行TL定位，病例更有可能被延迟（p = 0.002）且不可能成为首个开始的病例。两组在TL定位期间发生的血管迷走神经事件和术后使用麻醉剂的情况都很少见。
手术日之前进行TL定位与总住院时间缩短（p < 0.001）、病例延迟减少（p = 0.002）以及首个开始病例增加有关。这些发现表明手术日之前进行TL定位可能具有优势。
