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Parisi S, Ruggiero R, Gualtieri G, Volpe ML, Rinaldi S, Nesta G, Bogdanovich L, Lucido FS, Tolone S, Parmeggiani D, Gambardella C, Docimo L. Combined LOCalizer™ and Intraoperative Ultrasound Localization: First Experience in Localization of Non-palpable Breast Cancer. In Vivo 2021; 35:1669-1676. [PMID: 33910851 DOI: 10.21873/invivo.12426] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/17/2021] [Accepted: 03/22/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Wire-guided localization is the gold-standard for the detection of non-palpable breast lesions, although with acknowledged limitations. The aim of this study was to evaluate the combined use of LOCalizerr™ (Hologic, Santa Carla, CA, USA), and intraoperative ultrasound (IOUS) for localization and surgery of non-palpable breast cancer. PATIENTS AND METHODS Patients with non-palpable breast lesions underwent localization procedure with LOCalizer™ and IOUS. After the placement of the marker, eight measures were made to guide the excision. LOCalizerr™ Pencil and IOUS were performed to obtain the distance between the dissection plane and the margins of lesions. RESULTS The procedure was feasible in the five enrolled patients and associated with clear oncological margins in all cases. Moreover, a high satisfaction according to Likert scale for surgeons, radiologists and patients, performing limited and tailored resections, was reported. CONCLUSION Combining LOCalizerr™ and IOUS is an effective method for locating non-palpable breast cancer, guarantying excellent oncological and cosmetic results.
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Affiliation(s)
- Simona Parisi
- Department of Advanced Science and Surgery, General, Mini-invasive, Oncological and Obesity Surgery, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Roberto Ruggiero
- Department of Advanced Science and Surgery, General, Mini-invasive, Oncological and Obesity Surgery, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Giorgia Gualtieri
- Department of Advanced Science and Surgery, General, Mini-invasive, Oncological and Obesity Surgery, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Mariachiara Lanza Volpe
- Department of Advanced Science and Surgery, General, Mini-invasive, Oncological and Obesity Surgery, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Serena Rinaldi
- Department of Advanced Science and Surgery, General, Mini-invasive, Oncological and Obesity Surgery, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Giusiana Nesta
- Department of Advanced Science and Surgery, General, Mini-invasive, Oncological and Obesity Surgery, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Lidija Bogdanovich
- Department of Advanced Science and Surgery, General, Mini-invasive, Oncological and Obesity Surgery, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Francesco Saverio Lucido
- Department of Advanced Science and Surgery, General, Mini-invasive, Oncological and Obesity Surgery, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Salvatore Tolone
- Department of Advanced Science and Surgery, General, Mini-invasive, Oncological and Obesity Surgery, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Domenico Parmeggiani
- Department of Advanced Science and Surgery, General, Mini-invasive, Oncological and Obesity Surgery, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Claudio Gambardella
- Department of Advanced Science and Surgery, General, Mini-invasive, Oncological and Obesity Surgery, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Ludovico Docimo
- Department of Advanced Science and Surgery, General, Mini-invasive, Oncological and Obesity Surgery, Luigi Vanvitelli University of Campania, Naples, Italy
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Malter W, Eichler C, Hanstein B, Mallmann P, Holtschmidt J. First Reported Use of Radiofrequency Identification (RFID) Technique for Targeted Excision of Suspicious Axillary Lymph Nodes in Early Stage Breast Cancer - Evaluation of Feasibility and Review of Current Recommendations. In Vivo 2021; 34:1207-1213. [PMID: 32354911 DOI: 10.21873/invivo.11894] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/15/2020] [Accepted: 03/16/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND/AIM The purpose of this study was to evaluate, whether radio frequency identification (RFID) labeling of axillary lymph nodes (LNs) for the use of targeted resection is feasible in primary breast cancer patients with suspicious LNs. PATIENTS AND METHODS We analyzed 10 consecutive patients where RFID technique was used for intraoperative detection of suspicious LNs without preceding neoadjuvant chemotherapy (NACT). We compared the specifics of these procedures to 10 consecutive sentinel lymph node biopsies (SLNB) in the cN0 situation. RESULTS Intraoperative detection rate (DR) for the RFID-labeled target lymph node (TLN) was 100%. Perioperative complications were infrequent and comparable to SLNB. Average time for location of the RFID labeled TLN was quicker than for the SLN. In 71.4% the chip bearing TLN equaled a SLN. CONCLUSION The use of the RFID technique for intraoperative localization of axillary LNs for targeted excision seems feasible. RFID technique for targeted axillary dissection (TAD) following NACT should be investigated in a prospective manner.
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Affiliation(s)
- Wolfram Malter
- Department of Obstetrics and Gynecology, Faculty of Medicine, University Hospital of Cologne, Cologne, Germany
| | - Christian Eichler
- Department of Obstetrics and Gynecology, Faculty of Medicine, University Hospital of Cologne, Cologne, Germany
| | - Bettina Hanstein
- Department of Obstetrics and Gynecology, Faculty of Medicine, University Hospital of Cologne, Cologne, Germany
| | - Peter Mallmann
- Department of Obstetrics and Gynecology, Faculty of Medicine, University Hospital of Cologne, Cologne, Germany
| | - Johannes Holtschmidt
- Department of Obstetrics and Gynecology, Faculty of Medicine, University Hospital of Cologne, Cologne, Germany
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Malter W, Holtschmidt J, Thangarajah F, Mallmann P, Krug B, Warm M, Eichler C. First Reported Use of the Faxitron LOCalizer™ Radiofrequency Identification (RFID) System in Europe - A Feasibility Trial, Surgical Guide and Review for Non-palpable Breast Lesions. In Vivo 2020; 33:1559-1564. [PMID: 31471405 DOI: 10.21873/invivo.11637] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 06/20/2019] [Accepted: 06/27/2019] [Indexed: 01/18/2023]
Abstract
BACKGROUND/AIM The problem of adequately marking any given lesion within a breast surgical site is commonly solved by introducing a titanium clip. However, clip dislocation and/or stereotactic hook-wire dislocation are common problems. An ideal solution would be a clip that can be easily found without the use of stereotactic intervention. This work reviews the available data on radiofrequency identification devices (RFID) in breast surgery, reports initial experience data in Europe and discusses surgical pitfalls, advantages and disadvantages. PATIENTS AND METHODS This study represents a single center, consecutively recruited, initiation trial with subsequent surgeon questionnaire for the first institution in Europe to report Faxitron LOCalizer™ chip data. Four patients with non-palpable tumors were marked with the system and were correlated via mammography, pre- and intra-operative ultrasound and pathology. Data were then compared to available literature and a literature review was added. RESULTS The four patients marked with this RFID system, displayed a 100% success location rate at a 0% complication rate. Surgeons evaluated the new system as being safe to use and only slightly more difficult to place compared to a standard clip. A significant improvement in ultrasound localization and intraoperative localization was also reported for the LOCalizer™ system when compared to a standard titanium clip. CONCLUSION This trial added a small number of consecutively recruited patients to an existing number of available data, resulting in a total of 121 evaluated and reviewed Faxitron LOCalizer™ marked non-palpable in-breast lesions worldwide.
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Affiliation(s)
- Wolfram Malter
- University of Cologne, Faculty of Faculty of Medicine and University Hospital Cologne, Department of Obstetrics and Gynecology, Cologne, Germany
| | - Johannes Holtschmidt
- University of Cologne, Faculty of Faculty of Medicine and University Hospital Cologne, Department of Obstetrics and Gynecology, Cologne, Germany
| | - Fabinshy Thangarajah
- University of Cologne, Faculty of Faculty of Medicine and University Hospital Cologne, Department of Obstetrics and Gynecology, Cologne, Germany
| | - Peter Mallmann
- University of Cologne, Faculty of Faculty of Medicine and University Hospital Cologne, Department of Obstetrics and Gynecology, Cologne, Germany
| | - Barbara Krug
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Radiology, Cologne, Germany
| | - Mathias Warm
- University of Cologne, Faculty of Faculty of Medicine and University Hospital Cologne, Department of Obstetrics and Gynecology, Cologne, Germany.,Breast Cancer Center, Municipal Hospital Holweide, Cologne, Germany
| | - Christian Eichler
- University of Cologne, Faculty of Faculty of Medicine and University Hospital Cologne, Department of Obstetrics and Gynecology, Cologne, Germany
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