A comparison of stereotactic and tomosynthesis‐guided localisation of impalpable breast lesions
Abstract Introduction Impalpable breast cancers require precise pre‐operative lesion localisation to minimise re‐excision rates. Conventional techniques include hookwire insertion using stereotactic guidance. Newer techniques include the use of tomosynthesis guidance and the use of iodine‐125 seeds....
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-09-01
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| Series: | Journal of Medical Radiation Sciences |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jmrs.348 |
| _version_ | 1818295333043568640 |
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| author | Carolyn Madeley Meredith Kessell Chris Madeley Donna Taylor |
| author_facet | Carolyn Madeley Meredith Kessell Chris Madeley Donna Taylor |
| author_sort | Carolyn Madeley |
| collection | DOAJ |
| description | Abstract Introduction Impalpable breast cancers require precise pre‐operative lesion localisation to minimise re‐excision rates. Conventional techniques include hookwire insertion using stereotactic guidance. Newer techniques include the use of tomosynthesis guidance and the use of iodine‐125 seeds. This study compares the accuracy of lesion localisation with hookwire or seed insertion using prone stereotactic or upright tomosynthesis guidance. Methods This registered quality improvement activity did not require formal ethics approval. The post‐localisation images for 116 lesions were reviewed. The distance from the lesion or breast biopsy marker to the hookwire or seed was measured on post‐insertion mammograms. The relative placement accuracy of hookwire or seed using prone stereotactic or upright tomosynthesis guidance was compared. A lesion to seed or wire distance > 10 mm was considered technically unsatisfactory. Results 94.8% of the seeds and wires inserted via prone stereotactic guidance were accurately placed, compared with 89.6% of those inserted via upright tomosynthesis. There were twice as many technically unsatisfactory insertions under upright tomosynthesis guidance. The majority of the unsatisfactory insertions using upright tomosynthesis occurred when the lesion was at or below the level of the nipple and the insertion was performed craniocaudally. Conclusion The degree of accuracy of pre‐operative localisation of impalpable breast lesions is significantly higher with the use of prone stereotactic rather than upright tomosynthesis guidance. This was most evident with the placement of I‐125 seeds, and in cases where the target lesion was located below the level of the nipple. |
| first_indexed | 2024-12-13T03:45:58Z |
| format | Article |
| id | doaj.art-12bc4e64534245a9bd67942c7549f5ff |
| institution | Directory Open Access Journal |
| issn | 2051-3895 2051-3909 |
| language | English |
| last_indexed | 2024-12-13T03:45:58Z |
| publishDate | 2019-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Medical Radiation Sciences |
| spelling | doaj.art-12bc4e64534245a9bd67942c7549f5ff2022-12-22T00:00:50ZengWileyJournal of Medical Radiation Sciences2051-38952051-39092019-09-0166317017610.1002/jmrs.348A comparison of stereotactic and tomosynthesis‐guided localisation of impalpable breast lesionsCarolyn Madeley0Meredith Kessell1Chris Madeley2Donna Taylor3Department of Diagnostic and Interventional Radiology Royal Perth Hospital Perth Western Australia AustraliaDepartment of Diagnostic and Interventional Radiology Royal Perth Hospital Perth Western Australia AustraliaSEA Pty LTD Perth Western Australia AustraliaDepartment of Diagnostic and Interventional Radiology Royal Perth Hospital Perth Western Australia AustraliaAbstract Introduction Impalpable breast cancers require precise pre‐operative lesion localisation to minimise re‐excision rates. Conventional techniques include hookwire insertion using stereotactic guidance. Newer techniques include the use of tomosynthesis guidance and the use of iodine‐125 seeds. This study compares the accuracy of lesion localisation with hookwire or seed insertion using prone stereotactic or upright tomosynthesis guidance. Methods This registered quality improvement activity did not require formal ethics approval. The post‐localisation images for 116 lesions were reviewed. The distance from the lesion or breast biopsy marker to the hookwire or seed was measured on post‐insertion mammograms. The relative placement accuracy of hookwire or seed using prone stereotactic or upright tomosynthesis guidance was compared. A lesion to seed or wire distance > 10 mm was considered technically unsatisfactory. Results 94.8% of the seeds and wires inserted via prone stereotactic guidance were accurately placed, compared with 89.6% of those inserted via upright tomosynthesis. There were twice as many technically unsatisfactory insertions under upright tomosynthesis guidance. The majority of the unsatisfactory insertions using upright tomosynthesis occurred when the lesion was at or below the level of the nipple and the insertion was performed craniocaudally. Conclusion The degree of accuracy of pre‐operative localisation of impalpable breast lesions is significantly higher with the use of prone stereotactic rather than upright tomosynthesis guidance. This was most evident with the placement of I‐125 seeds, and in cases where the target lesion was located below the level of the nipple.https://doi.org/10.1002/jmrs.348accuracybreastlesion localisationstereotactictomosynthesis |
| spellingShingle | Carolyn Madeley Meredith Kessell Chris Madeley Donna Taylor A comparison of stereotactic and tomosynthesis‐guided localisation of impalpable breast lesions Journal of Medical Radiation Sciences accuracy breast lesion localisation stereotactic tomosynthesis |
| title | A comparison of stereotactic and tomosynthesis‐guided localisation of impalpable breast lesions |
| title_full | A comparison of stereotactic and tomosynthesis‐guided localisation of impalpable breast lesions |
| title_fullStr | A comparison of stereotactic and tomosynthesis‐guided localisation of impalpable breast lesions |
| title_full_unstemmed | A comparison of stereotactic and tomosynthesis‐guided localisation of impalpable breast lesions |
| title_short | A comparison of stereotactic and tomosynthesis‐guided localisation of impalpable breast lesions |
| title_sort | comparison of stereotactic and tomosynthesis guided localisation of impalpable breast lesions |
| topic | accuracy breast lesion localisation stereotactic tomosynthesis |
| url | https://doi.org/10.1002/jmrs.348 |
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