Ultrasound-guided percutaneous insertion of small vascular surgical clips versus dedicated breast mammoclips as markers for breast cancer prior to neo-adjuvant therapy: a prospective randomized controlled trial

Abstract

AimTo investigate the feasibility of applying small vascular surgical clips as tissue markers for breast cancer in patients scheduled for neoadjuvant chemotherapy (NAC) in comparison with the dedicated breast clips with assessment of their different complications.Patients and methodsThis prospective randomized controlled trial included 160 female patients with breast cancer whose neoadjuvant chemotherapy was required for their management. Patients were randomly allocated into 2 groups; group I for patients who were subjected to the insertion of the small vascular surgical clips, and Group II for patients who were subjected to the insertion of the dedicated breast clips (UltraClips®). Assessment of the feasibility of the application of the vascular surgical clips and detection of the complications of the vascular surgical clips compared to the UltraClip® commercial clips were the endpoints of this study.ResultsVascular surgical clips application had significantly longer duration than the duration of application of the UltraClips® (9.10 ± 2.67 min, and 5.44 ± 1.09 min respectively, P < 0.001). The application of vascular surgical clips was feasible in all patients. There were more incidences of non-deployment (6 patients) and mal-deployment (4 patients) in group I, compared to one patient and 2 patients in group II, respectively. All patients of non-deployment and mal-deployment in both groups had reapplication of other clips successfully. There were no significant differences between the two groups regarding incidence of complications.ConclusionsThe spinal needle/surgical vascular clip technique seems to be a cheap and effective alternative to the dedicated commercial mammoclips when required, with convenient results and minimal complications.