TY - JOUR
T1 - Localization Techniques for Non-Palpable Breast Lesions
T2 - Current Status, Knowledge Gaps, and Rationale for the MELODY Study (EUBREAST-4/iBRA-NET, NCT 05559411)
AU - Banys-Paluchowski, Maggie
AU - Kühn, Thorsten
AU - Masannat, Yazan
AU - Rubio, Isabel
AU - de Boniface, Jana
AU - Ditsch, Nina
AU - Karadeniz Cakmak, Güldeniz
AU - Karakatsanis, Andreas
AU - Dave, Rajiv
AU - Hahn, Markus
AU - Potter, Shelley
AU - Kothari, Ashutosh
AU - Gentilini, Oreste Davide
AU - Gulluoglu, Bahadir M
AU - Lux, Michael Patrick
AU - Smidt, Marjolein
AU - Weber, Walter Paul
AU - Aktas Sezen, Bilge
AU - Krawczyk, Natalia
AU - Hartmann, Steffi
AU - Di Micco, Rosa
AU - Nietz, Sarah
AU - Malherbe, Francois
AU - Cabioglu, Neslihan
AU - Canturk, Nuh Zafer
AU - Gasparri, Maria Luisa
AU - Murawa, Dawid
AU - Harvey, James
N1 - Publisher Copyright:
© 2023 by the authors.
PY - 2023/2/12
Y1 - 2023/2/12
N2 - BACKGROUND: Surgical excision of a non-palpable breast lesion requires a localization step. Among available techniques, wire-guided localization (WGL) is most commonly used. Other techniques (radioactive, magnetic, radar or radiofrequency-based, and intraoperative ultrasound) have been developed in the last two decades with the aim of improving outcomes and logistics.METHODS: We performed a systematic review on localization techniques for non-palpable breast cancer.RESULTS: For most techniques, oncological outcomes such as lesion identification and clear margin rate seem either comparable with or better than for WGL, but evidence is limited to small cohort studies for some of the devices. Intraoperative ultrasound is associated with significantly higher negative margin rates in meta-analyses of randomized clinical trials (RCTs). Radioactive techniques were studied in several RCTs and are non-inferior to WGL. Smaller studies show higher patient preference towards wire-free localization, but little is known about surgeons' and radiologists' attitudes towards these techniques.CONCLUSIONS: Large studies with an additional focus on patient, surgeon, and radiologist preference are necessary. This review aims to present the rationale for the MELODY (NCT05559411) study and to enable standardization of outcome measures for future studies.
AB - BACKGROUND: Surgical excision of a non-palpable breast lesion requires a localization step. Among available techniques, wire-guided localization (WGL) is most commonly used. Other techniques (radioactive, magnetic, radar or radiofrequency-based, and intraoperative ultrasound) have been developed in the last two decades with the aim of improving outcomes and logistics.METHODS: We performed a systematic review on localization techniques for non-palpable breast cancer.RESULTS: For most techniques, oncological outcomes such as lesion identification and clear margin rate seem either comparable with or better than for WGL, but evidence is limited to small cohort studies for some of the devices. Intraoperative ultrasound is associated with significantly higher negative margin rates in meta-analyses of randomized clinical trials (RCTs). Radioactive techniques were studied in several RCTs and are non-inferior to WGL. Smaller studies show higher patient preference towards wire-free localization, but little is known about surgeons' and radiologists' attitudes towards these techniques.CONCLUSIONS: Large studies with an additional focus on patient, surgeon, and radiologist preference are necessary. This review aims to present the rationale for the MELODY (NCT05559411) study and to enable standardization of outcome measures for future studies.
UR - http://www.scopus.com/inward/record.url?scp=85149013535&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/278aeb6d-c771-3891-a9bf-6c134527c1c2/
U2 - 10.3390/cancers15041173
DO - 10.3390/cancers15041173
M3 - Scientific review articles
C2 - 36831516
SN - 2072-6694
VL - 15
JO - Cancers
JF - Cancers
IS - 4
M1 - 1173
ER -
