Image-Guided Localization Techniques for Surgical Excision of Non-Palpable Breast Lesions: An Overview of Current Literature and Our Experience with Preoperative Skin Tattoo
Abstract
:1. Introduction
2. Wire Guided Localization
3. Carbon Marking
4. Radio-Guided Occult Lesion Localization
5. Radioactive Seed Localization
6. Magnetic Seed Localization
7. Radiofrequency Identification Tags
8. Intraoperative Ultrasound
9. Preoperative Localization with a Skin Tattoo
10. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
- Sharma, R. Breast cancer incidence, mortality and mortality-to-incidence ratio (MIR) are associated with human development, 1990–2016: Evidence from Global Burden of Disease Study 2016. Breast Cancer 2019, 26, 428–445. [Google Scholar] [CrossRef] [PubMed]
- Moo, T.-A.; Sanford, R.; Dang, C.; Morrow, M. Overview of breast cancer therapy. PET Clin. 2018, 13, 339–354. [Google Scholar] [CrossRef] [PubMed]
- Franceschini, G.; Terribile, D.; Fabbri, C.; Magno, S.; D’Alba, P.; Chiesa, F.; Di Leone, A.; Masetti, R. Management of locally advanced breast cancer. Mini-review. Minerva Chir. 2007, 62, 249–255. Available online: http://europepmc.org/abstract/MED/17641585 (accessed on 8 November 2020). [PubMed]
- Fisher, B.; Anderson, S.; Bryant, J.; Margolese, R.G.; Deutsch, M.; Fisher, E.R.; Jeong, J.-H.; Wolmark, N. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N. Engl. J. Med. 2002, 347, 1233–1241. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Veronesi, U.; Cascinelli, N.; Mariani, L.; Greco, M.; Saccozzi, R.; Luini, A.; Aguilar, M.; Marubini, E. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N. Engl. J. Med. 2002, 347, 1227–1232. [Google Scholar] [CrossRef] [PubMed]
- Sanchez, A.M.; Franceschini, G.; D’Archi, S.; De Lauretis, F.; Scardina, L.; Di Giorgio, D.; Accetta, C.; Masetti, R. Results obtained with level II oncoplastic surgery spanning 20 years of breast cancer treatment: Do we really need further demonstration of reliability? Breast J. 2020, 26, 125–132. [Google Scholar] [CrossRef]
- Peterson, M.E.; Schultz, D.J.; Reynolds, C.; Solin, L.J. Outcomes in breast cancer patients relative to margin status after treatment with breast-conserving surgery and radiation therapy: The University of Pennsylvania experience. Int. J. Radiat. Oncol. Biol. Phys. 1999, 43, 1029–1035. [Google Scholar] [CrossRef]
- Singletary, S.E. Surgical margins in patients with early-stage breast cancer treated with breast conservation therapy. Am. J. Surg. 2002, 184, 383–393. [Google Scholar] [CrossRef]
- Corsi, F.; Sorrentino, L.; Bossi, D.; Sartani, A.; Foschi, D. preoperative localization and surgical margins in conservative breast surgery. Int. J. Surg. Oncol. 2013, 2013, 793819. [Google Scholar] [CrossRef] [Green Version]
- Park, C.C.; Mitsumori, M.; Nixon, A.; Recht, A.; Connolly, J.; Gelman, R.; Silver, B.; Hetelekidis, S.; Abner, A.; Harris, J.R.; et al. Outcome at 8 years after breast-conserving surgery and radiation therapy for invasive breast cancer: Influence of margin status and systemic therapy on local recurrence. J. Clin. Oncol. 2000, 18, 1668–1675. [Google Scholar] [CrossRef] [PubMed]
- Franceschini, G.; Sanchez, A.M.; Di Leone, A.; Magno, S.; Moschella, F.; Accetta, C.; Natale, M.; Di Giorgio, D.; Scaldaferri, A.; D’Archi, S.; et al. Update on the surgical management of breast cancer. Ann. Ital. Chir. 2015, 86, 89–99. [Google Scholar] [PubMed]
- Hayes, M.K. Update on preoperative breast localization. Radiol. Clin. N. Am. 2017, 55, 591–603. [Google Scholar] [CrossRef]
- Jeffries, D.O.; Dossett, L.A.; Jorns, J.M. Localization for breast surgery: The next generation. Arch. Pathol. Lab. Med. 2017, 141, 1324–1329. [Google Scholar] [CrossRef]
- Jackman, R.J.; Marzoni, F.A. Needle-localized breast biopsy: Why do we fail? Radiology 1997, 204, 677–684. [Google Scholar] [CrossRef]
- Bick, U.; Trimboli, R.M.; Athanasiou, A.; Balleyguier, C.; Baltzer, P.A.T.; Bernathova, M.; Borbély, K.; Brkljacic, B.; Carbonaro, L.A.; Clauser, P.; et al. Image-guided breast biopsy and localisation: Recommendations for information to women and referring physicians by the European Society of Breast Imaging. Insights Imaging 2020, 11, 1–18. [Google Scholar] [CrossRef]
- Riedl, C.C.; Pfarl, G.; Helbich, T.H.; Memarsadeghi, M.; Wagner, T.; Rudas, M.; Fuchsjäger, M. Comparison of wire versus carbon localization of non-palpable breast lesions. RöFo 2002, 174, 1126–1131. [Google Scholar] [CrossRef]
- Rose, A.; Collins, J.; Neerhut, P.; Bishop, C.; Mann, G.B. Carbon localisation of impalpable breast lesions. Breast 2003, 12, 264–269. [Google Scholar] [CrossRef]
- Tran, Q.; Mizumoto, R.; Tran, M.; Reintals, M.; Gounder, V. Carbon-track localisation as an adjunct to wire-guided excision of impalpable breast lesions: A retrospective cohort study. Int. J. Surg. Open 2019, 21, 7–11. [Google Scholar] [CrossRef]
- Öcal, K.; Dag, A.; Turkmenoglu, M.O.; Günay, E.C.; Yûcel, E.; Duce, M.N. Radioguided occult lesion localization versus wire-guided localization for non-palpable breast lesions: Randomized controlled trial. Clinics 2011, 66, 1003–1007. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- De Cicco, C.; Pizzamiglio, M.; Trifirò, G.; Luini, A.; Ferrari, M.; Prisco, G.; Galimberti, V.; Cassano, E.; Viale, G.; Intra, M.; et al. Radioguided occult lesion localisation (ROLL) and surgical biopsy in breast cancer. Technical aspects. Q. J. Nucl. Med. 2002, 46, 145–151. [Google Scholar] [PubMed]
- Luini, A.; Zurrida, S.; Paganelli, G.; Galimberti, V.; Sacchini, V.; Monti, S.; Veronesi, P.; Viale, G. Comparison of radioguided excision with wire localization of occult breast lesions. BJS 1999, 86, 522–525. [Google Scholar] [CrossRef] [PubMed]
- Gray, R.J.; Salud, C.; Nguyen, K.; Dauway, E.; Friedland, J.; Berman, C.; Peltz, E.; Whitehead, G.; Cox, C.E. Randomized prospective evaluation of a novel technique for biopsy or lumpectomy of nonpalpable breast lesions: Radioactive seed versus wire localization. Ann. Surg. Oncol. 2001, 8, 711–715. [Google Scholar] [CrossRef] [PubMed]
- Rao, R.; Moldrem, A.; Sarode, V.; White, J.; Amen, M.; Rao, M.; Andrews, V.; Euhus, D.; Radford, L.; Ulissey, M. Experience with seed localization for nonpalpable breast lesions in a public health care system. Ann. Surg. Oncol. 2010, 17, 3241–3246. [Google Scholar] [CrossRef] [PubMed]
- Gera, R.; Tayeh, S.; Al-Reefy, S.; Mokbel, K. Evolving role of magseed in wireless localization of breast lesions: Systematic review and pooled analysis of 1,559 procedures. Anticancer. Res. 2020, 40, 1809–1815. [Google Scholar] [CrossRef]
- Endomag. Available online: https://www.endomag.com/ (accessed on 11 November 2020).
- Zacharioudakis, K.; Down, S.; Bholah, Z.; Lee, S.; Khan, T.; Howe, M.; Maxwell, A.; Harvey, J. Is the future magnetic? Magseed localisation of non palpable breast cancer—A multicentre comparative cohort study. Breast 2019, 44, S112. [Google Scholar] [CrossRef]
- Thekkinkattil, D.; Kaushik, M.; Hoosein, M.; Al-Attar, M.; Pilgrim, S.; Gvaramadze, A.; Hyklova, L.; Jibril, A. A prospective, single-arm, multicentre clinical evaluation of a new localisation technique using non-radioactive Magseeds for surgery of clinically occult breast lesions. Clin. Radiol. 2019, 74, 974.e7–974.e11. [Google Scholar] [CrossRef]
- Mango, V.L.; Wynn, R.T.; Feldman, S.; Friedlander, L.; Desperito, E.; Patel, S.N.; Gomberawalla, A.; Ha, R. Beyond wires and seeds: Reflector-guided breast lesion localization and excision. Radiology 2017, 284, 365–371. [Google Scholar] [CrossRef]
- Mango, V.; Ha, R.; Gomberawalla, A.; Wynn, R.; Feldman, S. Evaluation of the SAVI SCOUT surgical guidance system for localization and excision of nonpalpable breast lesions: A feasibility study. Am. J. Roentgenol. 2016, 207, W69–W72. [Google Scholar] [CrossRef] [Green Version]
- Cox, C.E.; Garcia-Henriquez, N.; Glancy, M.J.; Whitworth, P.; Cox, J.M.; Themar-Geck, M.; Prati, R.; Jung, M.; Russell, S.; Appleton, K.; et al. Pilot study of a new nonradioactive surgical guidance technology for locating nonpalpable breast lesions. Ann. Surg. Oncol. 2016, 23, 1824–1830. [Google Scholar] [CrossRef]
- Jadeja, P.H.; Mango, V.; Patel, S.; Friedlander, L.; Desperito, E.; Ayala-Bustamante, E.; Wynn, R.; Chen-Seetoo, M.; Taback, B.; Feldman, S.; et al. Utilization of multiple SAVI SCOUT surgical guidance system reflectors in the same breast: A single-institution feasibility study. Breast J. 2018, 24, 531–534. [Google Scholar] [CrossRef]
- Colakovic, N.; Zdravkovic, D.; Skuric, Z.; Mrda, D.; Gacic, J.; Ivanovic, N. Intraoperative ultrasound in breast cancer surgery—from localization of non-palpable tumors to objectively measurable excision. World J. Surg. Oncol. 2018, 16, 1–7. [Google Scholar] [CrossRef] [PubMed]
- Haid, A.; Knauer, M.; Dunzinger, S.; Jasarevic, Z.; Köberle-Wührer, R.; Schuster, A.; Toeppker, M.; Haid, B.; Wenzl, E.; Offner, F. Intra-operative sonography: A valuable aid during breast-conserving surgery for occult breast cancer. Ann. Surg. Oncol. 2007, 14, 3090–3101. [Google Scholar] [CrossRef] [PubMed]
- Fortunato, L.; Penteriani, R.; Farina, M.; Vitelli, C.E.; Piro, F. Intraoperative ultrasound is an effective and preferable technique to localize non-palpable breast tumors. Eur. J. Surg. Oncol. (EJSO) 2008, 34, 1289–1292. [Google Scholar] [CrossRef]
- Ramos, M.; Díaz, J.C.; Ramos, T.; Ruano, R.; Aparicio, M.; Sancho, M.; González-Orús, J.M. Ultrasound-Guided Excision Combined with Intraoperative Assessment of Gross Macroscopic Margins Decreases the Rate of Reoperations for Non-Palpable Invasive Breast Cancer. Breast 2012, 22, 520–524. Available online: https://www.unboundmedicine.com/medline/citation/23110817/Ultrasound_guided_excision_combined_with_intraoperative_assessment_of_gross_macroscopic_margins_decreases_the_rate_of_reoperations_for_non_palpable_invasive_breast_cancer_ (accessed on 30 October 2020). [CrossRef]
- Hall, F.; Kopans, D.B.; Sadowsky, N.L.; Homer, M.J. Development of wire localization for occult breast lesions: Boston remembrances. Radiology 2013, 268, 622–627. [Google Scholar] [CrossRef] [Green Version]
- Homer, M.J.; Pile-Spellman, E.R. Needle localization of occult breast lesions with a curved-end retractable wire: Technique and pitfalls. Radiology 1986, 161, 547–548. [Google Scholar] [CrossRef]
- Liberman, L.; Kaplan, J.; Van Zee, K.J.; Morris, E.A.; LaTrenta, L.R.; Abramson, A.F.; Dershaw, D.D. Bracketing wires for preoperative breast needle localization. Am. J. Roentgenol. 2001, 177, 565–572. [Google Scholar] [CrossRef] [PubMed]
- Chan, B.K.; Wiseberg-Firtell, J.A.; Jois, R.H.; Jensen, K.; Audisio, R.A. Localization techniques for guided surgical excision of non-palpable breast lesions. Cochrane Database Syst. Rev. 2015, CD009206. [Google Scholar] [CrossRef]
- Lovrics, P.J.; Cornacchi, S.; Vora, R.; Goldsmith, C.; Kahnamoui, K. Systematic review of radioguided surgery for non-palpable breast cancer. Eur. J. Surg. Oncol. (EJSO) 2011, 37, 388–397. [Google Scholar] [CrossRef]
- Loving, V.A.; Edwards, D.B.; Roche, K.T.; Steele, J.R.; Sapareto, S.A.; Byrum, S.C.; Schomer, D.F. Monte Carlo simulation to analyze the cost-benefit of radioactive seed localization versus wire localization for breast-conserving surgery in fee-for-service health care systems compared with accountable care organizations. Am. J. Roentgenol. 2014, 202, 1383–1388. [Google Scholar] [CrossRef] [PubMed]
- Van Susante, J.; Barendregt, W.; Bruggink, E. Migration of the guide-wire into the pleural cavity after needle localization of breast lesions. Eur. J. Surg. Oncol. (EJSO) 1998, 24, 446–448. [Google Scholar] [CrossRef]
- Azoury, F.M.; Sayad, P.; Rizk, A. Thoracoscopic management of a pericardial migration of a breast biopsy localization wire. Ann. Thorac. Surg. 2009, 87, 1937–1939. [Google Scholar] [CrossRef]
- Volders, J.H.; Haloua, M.H.; Krekel, N.M.A.; Meijer, S.; Van Den Tol, P.M. Current status of ultrasound-guided surgery in the treatment of breast cancer. World J. Clin. Oncol. 2016, 7, 44–53. [Google Scholar] [CrossRef]
- Bronstein, A.D.; Kilcoyne, R.F.; Moe, R.E. Complications of needle localization of foreign bodies and nonpalpable breast lesions. Arch. Surg. 1988, 123, 775–779. [Google Scholar] [CrossRef]
- Svane, G. A Stereotaxic technique for preoperative marking of non-palpable breast lesions. Acta Radiol. Diagn. 1983, 24, 145–151. [Google Scholar] [CrossRef]
- Ruiz-Delgado, M.L.; López-Ruiz, J.A.; Sáiz-López, A. Abnormal mammography and sonography associated with foreign-body giant-cell reaction after stereotactic vacuum-assisted breast biopsy with carbon marking. Acta Radiol. 2008, 49, 1112–1118. [Google Scholar] [CrossRef]
- Salvador, G.L.O.; Barbieri, P.P.; Maschke, L.; Nunes, A.L.A.; Louveira, M.H.; Budel, V.M. Charcoal granuloma mimicking breast cancer: An emerging diagnosis. Acta Radiol. Open 2018, 7, 2058460118815726. [Google Scholar] [CrossRef] [Green Version]
- Luini, A.; Zurrida, S.; Galimberti, V.; Paganelli, G. Radioguided surgery of occult breast lesions. Eur. J. Cancer. 1998, 34, 204–205. [Google Scholar] [CrossRef]
- Grüning, T.; Brogsitter, C.; Jones, I.W.; Heales, J.C. Resolution recovery in planar bone scans: Diagnostic value in metastatic disease. Nucl. Med. Commun. 2012, 33, 1307–1310. Available online: https://journals.lww.com/nuclearmedicinecomm/Fulltext/2012/12000/Resolution_recovery_in_planar_bone_scans__.11.aspx (accessed on 27 October 2020). [CrossRef]
- Monti, S.; Galimberti, V.; Trifirò, G.; De Cicco, C.; Peradze, N.; Brenelli, F.; Fernandez-Rodriguez, J.; Rotmensz, N.; Latronico, A.; Berrettini, A.; et al. Occult breast lesion localization plus Sentinel Node Biopsy (SNOLL): Experience with 959 patients at the European Institute of Oncology. Ann. Surg. Oncol. 2007, 14, 2928–2931. [Google Scholar] [CrossRef] [PubMed]
- Follacchio, G.A.; Monteleone, F.; Anibaldi, P.; De Vincentis, G.; Iacobelli, S.; Merola, R.; D’Orazi, V.; Monti, M.; Pasta, V. A modified sentinel node and occult lesion localization (SNOLL) technique in non-palpable breast cancer: A pilot study. J. Exp. Clin. Cancer Res. 2015, 34, 1–7. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Pavlicek, W.; Walton, H.A.; Karstaedt, P.J.; Gray, R.J. Radiation safety with use of I-125 seeds for localization of nonpalpable breast lesions. Acad. Radiol. 2006, 13, 909–915. [Google Scholar] [CrossRef]
- Goudreau, S.H.; Joseph, J.P.; Seiler, S.J. Preoperative radioactive seed localization for nonpalpable breast lesions: Technique, pitfalls, and solutions. Radiographics 2015, 35, 1319–1334. [Google Scholar] [CrossRef] [Green Version]
- Jakub, J.W.; Gray, R.J.; Degnim, A.C.; Boughey, J.C.; Gardner, M.; Cox, C.E. Current status of radioactive seed for localization of non palpable breast lesions. Am. J. Surg. 2010, 199, 522–528. [Google Scholar] [CrossRef]
- Sharek, D.; Zuley, M.L.; Zhang, J.Y.; Soran, A.; Ahrendt, G.M.; Ganott, M.A. Radioactive seed localization versus wire localization for lumpectomies: A comparison of outcomes. Am. J. Roentgenol. 2015, 204, 872–877. [Google Scholar] [CrossRef]
- Bloomquist, E.V.; Ajkay, N.; Patil, S.; Collett, A.E.; Frazier, T.G.; Barrio, A.V. A randomized prospective comparison of patient-assessed satisfaction and clinical outcomes with radioactive seed localization versus wire localization. Breast J. 2016, 22, 151–157. [Google Scholar] [CrossRef] [Green Version]
- Langhans, L.; Tvedskov, T.F.; Klausen, T.L.; Jensen, M.-B.; Talman, M.-L.; Vejborg, I.; Benian, C.; Roslind, A.; Hermansen, J.; Oturai, P.S.; et al. Radioactive seed localization or wire-guided localization of nonpalpable invasive and in situ breast cancer: A randomized, multicenter, open-label trial. Ann. Surg. 2017, 266, 29–35. [Google Scholar] [CrossRef]
- Harvey, J.R.; Lim, Y.; Murphy, J.; Howe, M.; Morris, J.; Goyal, A.; Maxwell, A.J. Safety and feasibility of breast lesion localization using magnetic seeds (Magseed): A multi-centre, open-label cohort study. Breast Cancer Res. Treat. 2018, 169, 531–536. [Google Scholar] [CrossRef] [Green Version]
- Haloua, M.H.; Volders, J.H.; Krekel, N.M.; Lopes Cardozo, A.M.F.; De Roos, W.K.; De Widt-Levert, L.M.; Van Der Veen, H.; Rijna, H.; Bergers, E.; Jóźwiak, K.; et al. Intraoperative ultrasound guidance in breast-conserving surgery improves cosmetic outcomes and patient satisfaction: Results of a Multicenter Randomized Controlled Trial (COBALT). Ann. Surg. Oncol. 2016, 23, 30–37. [Google Scholar] [CrossRef] [Green Version]
- James, T.A.; Harlow, S.; Sheehey-Jones, J.; Hart, M.; Gaspari, C.; Stanley, M.; Krag, D.; Ashikaga, T.; McCahill, L.E. Intraoperative ultrasound versus mammographic needle localization for ductal carcinoma in situ. Ann. Surg. Oncol. 2009, 16, 1164–1169. [Google Scholar] [CrossRef]
- Gerrard, A.D.; Shrotri, A. Surgeon-led intraoperative ultrasound localization for nonpalpable breast cancers: Results of 5 years of practice. Clin. Breast Cancer 2019, 19, e748–e752. [Google Scholar] [CrossRef] [PubMed]
- Krekel, N.M.; Cardozo, A.L.F.; Muller, S.; Bergers, E.; Meijer, S.; van den Tol, M. Optimising surgical accuracy in palpable breast cancer with intra-operative breast ultrasound—Feasibility and surgeons’ learning curve. Eur. J. Surg. Oncol. (EJSO) 2011, 37, 1044–1050. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Dogan, B.E.; Whitman, G.J. Intraoperative breast ultrasound. Semin. Roentgenol. 2011, 46, 280–284. [Google Scholar] [CrossRef]
- Carlino, G.; Rinaldi, P.; Giuliani, M.; Rella, R.; Bufi, E.; Padovano, F.; Ciardi, C.; Romani, M.; Belli, P.; Manfredi, R. Ultrasound-guided preoperative localization of breast lesions: A good choice. J. Ultrasound 2019, 22, 85–94. [Google Scholar] [CrossRef] [PubMed]
- Franceschini, G.; Visconti, G.; Sanchez, A.M.; Di Leone, A.; Salgarello, M.; Masetti, R. Oxidized regenerated cellulose in breast surgery: Experimental model. J. Surg. Res. 2015, 198, 237–244. [Google Scholar] [CrossRef]
- Madeley, C.; Kessell, M.; Madeley, C.; Taylor, D.B. A comparison of stereotactic and tomosynthesis-guided localisation of impalpable breast lesions. J. Med. Radiat. Sci. 2019, 66, 170–176. [Google Scholar] [CrossRef] [Green Version]
- Fusco, R.; Petrillo, A.; Catalano, O.; Sansone, M.; Granata, V.; Filice, S.; D’Aiuto, M.; Pankhurst, Q.; Douek, M. Procedures for location of non-palpable breast lesions: A systematic review for the radiologist. Breast Cancer 2012, 21, 522–531. [Google Scholar] [CrossRef]
Technique | Materials/Procedures | Advantages | Disadvantages | Success * Rate | Clear Margins Rate |
---|---|---|---|---|---|
Wire localization | Wire Preloaded needle introducer | Simple Cost-effective Different kinds of image-guidance | Wire migration Scheduling difficulties Limits surgical decisions | 97.5% [14] | 70.8–87.4% [15] |
Carbon marking | Diluted charcoal powder | Simple Different kinds of image-guidance Cost-effective Cannot dislodge Scheduling flexibility | Carbon can distort or obscure lesion Unfit for large breasts Unfit for multifocal or extensive lesions | 99% [16] | 61–85% [17,18] |
ROLL | Nuclear radiotracer Technetium 99 Gamma ray probe | Different kinds of image-guidance Does not limit surgeon | Scheduling difficulties Radiation Cost | 95–99% [19] | 92% [20,21] |
RSL | Iodine 125 seed Preloaded needle introducer Gamma probe set for I-125 | Scheduling flexibility Does not limit surgeon Different kinds of image-guidance | Radiation Not repositionable after deployment | 100% [22,23] | 73.5–96.7% [22,23] |
Magseed | Paramagnetic seed Preloaded needle introducer | Scheduling flexibility No radiation Does not limit surgeon | Cost Not repositionable after deployment Non magnetizable surgical equipment MRI artifacts | 99.86% [24,25,26,27] | 88.75% [24] |
Radiofrequency identification tags | Radiofrequency reflector Needle introducer Detector | Scheduling flexibility No radiation Does not limit surgeon | Cost Depth limit Not repositionable after deployment Interference with halogen lights in the OR | 97–100% [28,29] | 85–100% [28,29,30] |
IOUS | Portable or OR-stationed US machine and sterile transducer cover | Scheduling flexibility No radiation Does not limit surgeon Non-invasive | Unemployable in US-invisible lesions Surgeon learning curve Interference with air during dissection | 100% [31,32,33,34,35] | 81–97% [32,34] |
Skin tattoo | Dermographic marker Lead markers | Simple and safe Cost-effective Non-invasive Different kinds of image-guidance Does not limit surgeon | Scheduling difficulties Inability to depict marker | 99.5% ** | 95.9% ** |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Franceschini, G.; Mason, E.J.; Grippo, C.; D’Archi, S.; D’Angelo, A.; Scardina, L.; Sanchez, A.M.; Conti, M.; Trombadori, C.; Terribile, D.A.; et al. Image-Guided Localization Techniques for Surgical Excision of Non-Palpable Breast Lesions: An Overview of Current Literature and Our Experience with Preoperative Skin Tattoo. J. Pers. Med. 2021, 11, 99. https://doi.org/10.3390/jpm11020099
Franceschini G, Mason EJ, Grippo C, D’Archi S, D’Angelo A, Scardina L, Sanchez AM, Conti M, Trombadori C, Terribile DA, et al. Image-Guided Localization Techniques for Surgical Excision of Non-Palpable Breast Lesions: An Overview of Current Literature and Our Experience with Preoperative Skin Tattoo. Journal of Personalized Medicine. 2021; 11(2):99. https://doi.org/10.3390/jpm11020099
Chicago/Turabian StyleFranceschini, Gianluca, Elena Jane Mason, Cristina Grippo, Sabatino D’Archi, Anna D’Angelo, Lorenzo Scardina, Alejandro Martin Sanchez, Marco Conti, Charlotte Trombadori, Daniela Andreina Terribile, and et al. 2021. "Image-Guided Localization Techniques for Surgical Excision of Non-Palpable Breast Lesions: An Overview of Current Literature and Our Experience with Preoperative Skin Tattoo" Journal of Personalized Medicine 11, no. 2: 99. https://doi.org/10.3390/jpm11020099