Clip and wire localization of locally advanced malignant breast masses in patients undergoing neoadjuvant chemotherapy and breast conservation therapy

Lamiaa Adel Salah El Din Shalaby,Emad Salah El Din Khallaf,Mohamed Mahmoud Moussa

doi:10.1186/s43055-019-0066-z

Lamiaa Adel Salah El Din Shalaby, Emad Salah El Din Khallaf + Show 1 more

Open Access

https://doi.org/10.1186/s43055-019-0066-z

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Abstract

BackgroundIn locally advanced breast cancers, the use of preoperative systemic therapy has been shown to induce tumor response and to improve the local control rate after subsequent surgery and radiation therapy. The purpose of the study is to evaluate the accuracy of localization of breast malignant masses in patients who received neoadjuvant chemotherapy and will undergo conservative breast surgery by using clip and wire marker.ResultsClip placement was done in 20/20 cases (100%). There was no mammographic evidence of clip migration or complication related to the clip insertion. Wire localization of tumor bed marked by radiopaque clip 1-day preoperative was done in 18/20 patient (90%), the other 2 patients, the masses were clinically palpable (10%). Accurate localization by wire was positive in 18/18 cases. Clip and wire retrieval were positive in all cases.ConclusionClip markers can be used for tumor localization in breast cancer patients undergoing neoadjuvant chemotherapy without migration. Clips are tolerated and safe for the patient, easily visualized on imaging, do not interfere with treatment response, and are cost-effective. Also, serves as a guide for post-neoadjuvant chemotherapy localization when the tumor is not palpable.

Highlights

In locally advanced breast cancers, the use of preoperative systemic therapy has been shown to induce tumor response and to improve the local control rate after subsequent surgery and radiation therapy
Mastectomy followed by postmastectomy radiation has been the standard of treatment for patients with locally advanced breast cancer (LABC) in that a breast-conserving approach for patients with larger primary tumors may not have been technically feasible, may not have been as effective, and may have resulted in significant cosmetic deformity
No complication related to the clip insertion was noted during the study period, and no patient complained of heat sensation or pain

Summary

Introduction

In locally advanced breast cancers, the use of preoperative systemic therapy has been shown to induce tumor response and to improve the local control rate after subsequent surgery and radiation therapy. Neoadjuvant chemotherapy (NAC) has been the accepted standard of care for patients with operable or inoperable breast cancers. The benefits of NAC performed prior to surgery are as follows: (1) reduction of mortality; (2) improvement of surgical options, such as conversion to breast-conserving surgery (BCS) in operable patients, as well as surgery in previously inoperable patients; and (3) early collection of information on the treatment response and tumor biology of the breast cancer [4, 5].

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