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Ultrasound-guided lumpectomy of nonpalpable breast cancer versus wire-guided resection: A randomized clinical trial

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Abstract

Background

The wire-guided excision of nonpalpable breast cancer often results in tumor resections with inadequate margins. This prospective, randomized trial was undertaken to investigate whether intraoperative ultrasound (US) guidance enables a better margin clearance than the wire-guided technique in the breast-conserving treatment of nonpalpable breast cancers.

Methods

Patients with a preoperative histological diagnosis of nonpalpable breast cancer that could be visualized both with US and mammography were included. Patients were randomized to undergo either a wire-guided or a US-guided excision. Adequate margins were defined as ≥1 mm.

Results

Of 49 included patients, 23 were assigned to undergo wire-guided excision and 26 to undergo US-guided excision. One patient crossed over to US-guided excision after inadvertent wire displacement. Mean tumor diameter, specimen weight, and operating time were similar in both groups. The excision was adequate in 24 (89%) of 27 US-guided excisions and 12 (55%) of 22 wire-guide excisions (P=.007).

Conclusions

US-guided excision seems to be superior to wire-guided excision with respect to margin clearance of mammographically detected and US-visible nonpalpable breast cancers. Patients do not have to undergo the unpleasant wire placement before surgery.

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Authors and Affiliations

  1. Department of Surgery, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands

    Frans D. Rahusen MD

  2. Department of Surgical Oncology, De Boelelaan 1117, 1081 HV, Amsterdam

    Andre J. A. Bremers MD, Hans F. J. Fabry MD & S. Meijer MD, PhD

  3. Department of Radiology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands

    A. H. M. Taets van Amerongen MD

  4. Department of Surgery, District General Hospital, Amstelveen, The Netherlands

    Rob P. A. Boom MD

Authors
  1. Frans D. Rahusen MD
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  2. Andre J. A. Bremers MD
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  3. Hans F. J. Fabry MD
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  4. A. H. M. Taets van Amerongen MD
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  5. Rob P. A. Boom MD
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  6. S. Meijer MD, PhD
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Corresponding author

Correspondence to S. Meijer MD, PhD.

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Rahusen, F.D., Bremers, A.J.A., Fabry, H.F.J. et al. Ultrasound-guided lumpectomy of nonpalpable breast cancer versus wire-guided resection: A randomized clinical trial. Annals of Surgical Oncology 9, 994–998 (2002). https://doi.org/10.1007/BF02574518

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  • DOI: https://doi.org/10.1007/BF02574518

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