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05. Miscellaneous
1225 Surgical outcomes after radioactive 125I seed versus needle guided conservative surgery of non-palpable breast cancer
  1. Alvaro Sanz Diaz-Heredero,
  2. Victoria Pascual Escudero,
  3. Susana Cortes Perez,
  4. Jose Ignacio Gonzalez Martin,
  5. Paula Suarez Mansilla,
  6. Emma Puertas Ruiz,
  7. Patricia Legido Moran,
  8. Ricardo Ruano Perez,
  9. Javier Gomez Hidalgo,
  10. Martin Moral Cano,
  11. Esther Ruiz Perez,
  12. Lidia Casamayor Del Nogal,
  13. Jimena Bayon Pascual,
  14. Sandra Canales Martínez,
  15. Julio Alberto Gobernado Tejedor and
  16. Marta Ibañez Nieto
  1. Hospital Clínico Universitario de Valladolid, Valladolid, Spain

Abstract

Introduction/Background Marking of non-palpable breast lesions with 125I radioactive seeds is an alternative to conventional needle localization. The objective of this work is to compare post-operative results of conservative surgery of non-palpable breast cancer guided either with 125I radioactive seed or surgical wire in our institution.

Methodology Retrospective, analytic and descriptive study including 117 patients with non-palpable breast cancer, who were candidates for primary surgery from 1st January to 31st December 2022. During 2022, 125I seed marking was introduced in our institution, coexisting with needle localization. We recorded data from histological report such as volume, weight and greatest diameter of surgical specimen and surgical margins.

Results 72 patients underwent surgery by 125I radioactive seed localization and 45 by wire localization.

Regarding histological features, in wire excision group, 11.1% were ductal carcinoma in situ (DCIS), 80% invasive ductal carcinoma (IDC) and 4.4% invasive lobular carcinoma (ILC). In seed-marked group, distribution was similar with 8.3% DCIS, 84.7% IDC and 6.9% ILC.

Median of greatest specimen diameter was similar in both groups. In contrast, we found differences in specimen weight (30 g in needle-marked and 22.5 g in seed-marked tumors) and in specimen volume (50 cm3 vs 41.9 cm3). We also noted a wider range in wire excision.

15.6% of patients who underwent conservative surgery with needle localization showed affected margins of the specimen versus 8.3% in seed-marked patients.

We didn’t find any statistically significant differences in any of the variables analyzed.

Conclusion Seed-guided conservative breast cancer surgery is a safe and more confortable for patients marking approach for non-palpable breast lesions. Considering our results, this technique is related with smaller surgical specimens and lower rate of affected margins, which will reduce reintervention. Limitations of our work are small sample size, reducing statistical power (data from 2023 will be included in final analysis)

Disclosures NO.

https://doi.org/10.1136/ijgc-2024-ESGO.544

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