Comparison of Multiple Wire, Radioactive Seed, and Savi Scout® Radar Localizations for Management of Surgical Breast Disease

Abstract

Radioactive seed localization (RSL) and the Savi Scout® radar (SSR) are newer alternatives to wire-guided localization (WL) for nonpalpable breast lesions. The aim of this study was to compare three localization devices when multiple devices were used for preoperative localization for breast surgery. Between July 2017 and July 2018, 68 patients had a partial mastectomy (n=54) or breast biopsy (n=14) with preoperative image-guided localization using multiple wires or device placement for nonpalpable lesions. Operative timing, outcomes, and 30-day complications were evaluated. Overall, 41 patients (60%) had WL, 11 patients (16%) had RSL, and 16 patients (24%) had SSR localization. Fifty-four patients (79.4%) had localization of two lesions and 13 patients (19.1%) had localization of three lesions. Twenty-three patients (33.8%) had a lesion that was bracketed. There was no difference in retained biopsy clip among the groups (average 7.4%; p=0.962). For operations performed in the hospital, there was no difference in operative time among the groups, with a median of 77.5 min (p=0.705) or total perioperative time of 508 min (p=0.210). Among operations with delayed start times, there was a longer average delay of 95.5 min in WL, compared with 42 min in SSR (p=0.004). A greater volume of tissue was excised in the WL group (29.5g WL vs. 15.9g RSL vs. 12.1g SSR; p=0.022). There was no difference in positive margin rate and 30-day complications among groups. SSR and RSL can be used to localize multiple breast lesions, with no difference in positive margin rates or complications and less tissue excised compared with WL.