Portal de Periódicos da CAPES

Localization Techniques for Non-Palpable Breast Lesions: Current Status, Knowledge Gaps, and Rationale for the MELODY Study (EUBREAST-4/iBRA-NET, NCT 05559411)

2023; Multidisciplinary Digital Publishing Institute; Volume: 15; Issue: 4 Linguagem: Inglês

10.3390/cancers15041173

2072-6694

Maggie Banys‐Paluchowski, Thorsten Kühn, Yazan Masannat, Isabel T. Rubio, Jana de Boniface, Nina Ditsch, Güldeniz Karadeniz Çakmak, Andreas Karakatsanis, Rajiv Dave, Markus Hahn, Shelley Potter, Ashutosh Kothari, Oreste ­Gentilini, Bahadır M. Gūllūoḡlu, Michael P. Lux, Marjolein L. Smidt, William P. Weber, Bilge Aktas Sezen, Natalia Krawczyk, Steffi Hartmann, Rosa Di Micco, Sarah Nietz, Francois Malherbe, Neslihan Cabıoğlu, Nuh Zafer Cantürk, Maria Luisa Gasparri, Dawid Murawa, James Harvey,

MRI in cancer diagnosis

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.