J Med Assoc Thai 2021; 104 (10):1617-25

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The Analysis of Preoperative Wire Localization in Breast Conserving Surgery and Predictors of Surgical Margin Status
Wiratkapun C , Wattanatada P Mail

Background: At present, the breast conserving therapy (BCT) is considered a treatment of choice for early-stage breast cancer. BCT aims to achieve complete tumor resection with adequate margin and offers better cosmetic outcome.

Objective: To describe the experience with preoperative wire localization technique for early breast cancer and analysis of factors affecting positive margin status.

Materials and Methods: The authors retrospectively reviewed 190 patients with 206 malignant breast lesions treated by breast conserving surgery (BCS) after mammographic- or ultrasound- guided wire localization. Patient age, lesion type such as mass, mass with calcifications, calcifications alone, and architectural distortion, BI-RADS assessment categories, size, location, modalities of imaging guidance, number of wires used, radiological and surgical margin status, pathological diagnosis, and tumor focality were recorded.

Results: A 14.56% of positive surgical margin rate was observed. Mixed-effects logistic regression analysis showed larger lesion size was a significant predictor for positive surgical margin status at larger than 1.5 cm versus 1.0 cm or smaller (p=0.033).

Conclusion: The present study data suggested that larger tumor size is the only significant predictor for positive surgical margin status. To deal with non-palpable large tumor, surgeon and radiologist should pay particular attention to achieve adequate surgical margin.

Keywords: Wire localization; Breast conserving surgery; Surgical margin status; Specimen radiography

DOI: doi.org/10.35755/jmedassocthai.2021.10.12771

Received 9 April 2021 | Revised 5 August 2021 | Accepted 5 August 2021

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