Comparison of Wire and Non-Wire Localisation Techniques in Breast Cancer Surgery: A Review of the Literature with Pooled Analysis
<i>Background and Objectives:</i> Wide local excision is a common procedure in the treatment of breast cancer. Wire-guided localisation (WGL) has been the gold standard for many years; however, several issues have been identified with this technique, and therefore, wire-free techniques h...
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| Format: | Article |
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MDPI AG
2023-07-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/7/1297 |
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| author | Shahram Shirazi Hamed Hajiesmaeili Muskaan Khosla Saima Taj Tapan Sircar Raghavan Vidya |
| author_facet | Shahram Shirazi Hamed Hajiesmaeili Muskaan Khosla Saima Taj Tapan Sircar Raghavan Vidya |
| author_sort | Shahram Shirazi |
| collection | DOAJ |
| description | <i>Background and Objectives:</i> Wide local excision is a common procedure in the treatment of breast cancer. Wire-guided localisation (WGL) has been the gold standard for many years; however, several issues have been identified with this technique, and therefore, wire-free techniques have been developed. This scoping review synthesises the available literature comparing wire-guided localisation with the wire-free techniques used in breast-conserving cancer surgery. <i>Materials and Methods</i>: Multiple databases including Pubmed and MEDLINE were used to search articles between 1 January 2000 and 31 December 2022. Terms included “breast neoplasms”, “margins of excision”, and “reoperation”. In total, 34/256 papers were selected for review. Comparisons were made between positive margins and re-excision rates of WGL with wire-free techniques including SAVI SCOUT, Magseed, ROLL, and RSL. Pooled <i>p</i>-values were calculated using chi-square testing to determine statistical significance. <i>Results</i>: Pooled analysis demonstrated statistically significant reductions in positive margins and re-excision rates when SAVI SCOUT, RSL, and ROLL were compared with WGL. When SAVI SCOUT was compared to WGL, there were fewer re-excisions {(8.6% vs. 18.8%; <i>p</i> = 0.0001) and positive margins (10.6% vs. 15.0%; <i>p</i> = 0.0105)}, respectively. This was also the case in the ROLL and RSL groups. When compared to WGL; lower re-excision rates and positive margins were noted {(12.6% vs. 20.8%; <i>p</i> = 0.0007), (17.0% vs. 22.9%; <i>p</i> = 0.0268)} for ROLL and for RSL, respectively {(6.8% vs. 14.9%),(12.36% vs. 21.4%) (<i>p</i> = 0.0001)}. Magseed localisation demonstrated lower rates of re-excision than WGL (13.44% vs. 15.42%; <i>p</i> = 0.0534), but the results were not statistically significant. <i>Conclusions</i><b>:</b> SAVI SCOUT, Magseed, ROLL, and RSL techniques were reviewed. Pooled analysis indicates wire-free techniques, specifically SAVI SCOUT, ROLL, and RSL, provide statistically significant reductions in re-excision rates and positive margin rates compared to WGL. However, additional studies and systematic analysis are required to ascertain superiority between techniques. |
| first_indexed | 2024-03-11T00:50:34Z |
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| id | doaj.art-19db00dc74f645d8bf7751d1b3bc1923 |
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| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-11T00:50:34Z |
| publishDate | 2023-07-01 |
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| spelling | doaj.art-19db00dc74f645d8bf7751d1b3bc19232023-11-18T20:24:43ZengMDPI AGMedicina1010-660X1648-91442023-07-01597129710.3390/medicina59071297Comparison of Wire and Non-Wire Localisation Techniques in Breast Cancer Surgery: A Review of the Literature with Pooled AnalysisShahram Shirazi0Hamed Hajiesmaeili1Muskaan Khosla2Saima Taj3Tapan Sircar4Raghavan Vidya5Specialist Registrar in Breast Surgery, Princess Royal University Hospital, Kings College Hospital NHS Foundation Trust, London SE5 9RS, UKSpecialist Registrar in Breast Surgery, Royal Wolverhampton NHS Trust, Wolverhampton WV10 0QP, UKSenior Clinical Fellow in Breast Surgery, Royal Wolverhampton NHS Trust, Wolverhampton WV10 0QP, UKSenior Clinical Fellow in Breast Surgery, Royal Wolverhampton NHS Trust, Wolverhampton WV10 0QP, UKConsultant in Oncoplastic and Reconstructive Breast Surgery, Royal Wolverhampton NHS Trust, Wolverhampton WV10 0QP, UKConsultant in Oncoplastic and Reconstructive Breast Surgery, Royal Wolverhampton NHS Trust, Wolverhampton WV10 0QP, UK<i>Background and Objectives:</i> Wide local excision is a common procedure in the treatment of breast cancer. Wire-guided localisation (WGL) has been the gold standard for many years; however, several issues have been identified with this technique, and therefore, wire-free techniques have been developed. This scoping review synthesises the available literature comparing wire-guided localisation with the wire-free techniques used in breast-conserving cancer surgery. <i>Materials and Methods</i>: Multiple databases including Pubmed and MEDLINE were used to search articles between 1 January 2000 and 31 December 2022. Terms included “breast neoplasms”, “margins of excision”, and “reoperation”. In total, 34/256 papers were selected for review. Comparisons were made between positive margins and re-excision rates of WGL with wire-free techniques including SAVI SCOUT, Magseed, ROLL, and RSL. Pooled <i>p</i>-values were calculated using chi-square testing to determine statistical significance. <i>Results</i>: Pooled analysis demonstrated statistically significant reductions in positive margins and re-excision rates when SAVI SCOUT, RSL, and ROLL were compared with WGL. When SAVI SCOUT was compared to WGL, there were fewer re-excisions {(8.6% vs. 18.8%; <i>p</i> = 0.0001) and positive margins (10.6% vs. 15.0%; <i>p</i> = 0.0105)}, respectively. This was also the case in the ROLL and RSL groups. When compared to WGL; lower re-excision rates and positive margins were noted {(12.6% vs. 20.8%; <i>p</i> = 0.0007), (17.0% vs. 22.9%; <i>p</i> = 0.0268)} for ROLL and for RSL, respectively {(6.8% vs. 14.9%),(12.36% vs. 21.4%) (<i>p</i> = 0.0001)}. Magseed localisation demonstrated lower rates of re-excision than WGL (13.44% vs. 15.42%; <i>p</i> = 0.0534), but the results were not statistically significant. <i>Conclusions</i><b>:</b> SAVI SCOUT, Magseed, ROLL, and RSL techniques were reviewed. Pooled analysis indicates wire-free techniques, specifically SAVI SCOUT, ROLL, and RSL, provide statistically significant reductions in re-excision rates and positive margin rates compared to WGL. However, additional studies and systematic analysis are required to ascertain superiority between techniques.https://www.mdpi.com/1648-9144/59/7/1297localisationlocalizationnon-palpable breast lumpbreast cancerwire-guidedwire-free |
| spellingShingle | Shahram Shirazi Hamed Hajiesmaeili Muskaan Khosla Saima Taj Tapan Sircar Raghavan Vidya Comparison of Wire and Non-Wire Localisation Techniques in Breast Cancer Surgery: A Review of the Literature with Pooled Analysis Medicina localisation localization non-palpable breast lump breast cancer wire-guided wire-free |
| title | Comparison of Wire and Non-Wire Localisation Techniques in Breast Cancer Surgery: A Review of the Literature with Pooled Analysis |
| title_full | Comparison of Wire and Non-Wire Localisation Techniques in Breast Cancer Surgery: A Review of the Literature with Pooled Analysis |
| title_fullStr | Comparison of Wire and Non-Wire Localisation Techniques in Breast Cancer Surgery: A Review of the Literature with Pooled Analysis |
| title_full_unstemmed | Comparison of Wire and Non-Wire Localisation Techniques in Breast Cancer Surgery: A Review of the Literature with Pooled Analysis |
| title_short | Comparison of Wire and Non-Wire Localisation Techniques in Breast Cancer Surgery: A Review of the Literature with Pooled Analysis |
| title_sort | comparison of wire and non wire localisation techniques in breast cancer surgery a review of the literature with pooled analysis |
| topic | localisation localization non-palpable breast lump breast cancer wire-guided wire-free |
| url | https://www.mdpi.com/1648-9144/59/7/1297 |
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