The radioactive seed localization and wire guided localization for impalpable breast cancer surgery
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2023
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HTAI ANNUAL MEETING
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Introduction: Impalpable breast cancer requires an intraoperative localization to guide the surgical procedure. The
radioactive seed localization (RSL) technique uses the radioactive lodine-125 seed, while wire guided
localization (WGL) uses a metallic wire as a marker, implanting at the lesion site. The conservative surgery
success depends on the tumor's complete excision with negative surgical margins. The objective of this study
is to perform a meta-analysis of the surgical efficiency of both techniques, evaluating the rates of positive
surgical margins, reoperation, and recurrence.
Methods: The systematic research was performed in PubMed, Embase, LILACS, SciELO, and Web of Science. The terms
impalpable breast cancer, breast surgery, radioactive seed localization, and wire-guided localization, were
used for the search strategy. The selected studies went through a standard form of data extraction. The risk of
bias tools, ROBINS-1 and ROB-2, were applied to analyze the bias risk and methodological quality. The Review
Manager 5.4 software was used to perform the meta-analysis by the random effects analysis model.
Results: Six randomized controlled trials and 32 cohort studies were included. The evidence overall quality was high for
randomized trials and moderate for cohort studies. The population consists of women with non-palpable
breast cancer, aged 22 to 92 years old. The results demonstrated an RSL superiority over WGL for the rates of
positive surgical margin (relative risk (RR) 0.78, 95% confidence interval [Cl]:0.70,0.88, 15,085 patients),
reoperation (RR 0.71, 95% C1:0.61,0.84, 13,884 patients) and recurrence (RR 0.41, 95% CI:0.19,0.86, 1,525
patients, followed up for a period of 13-109 months).
Conclusions: The RSL technique is a valid and superior localization method for surgical efficiency for patients with non-
palpable breast cancer and can be applied in various indications for breast-conserving surgery with
intraoperative localization. Furthermore, the longer interval between seed implant and surgery, due to the
physical half-life of lodine-125 is 59.4 days, offers greater organization flexibility to the radiology and surgery
sectors, and to providing safety to those who undergo RSL before neoadjuvant chemotherapy and achieve a
complete pathological response.
Como referenciar
FERREIRA, HORTENCIA; ROSTELATO, MARIA E.C.M. The radioactive seed localization and wire guided localization for impalpable breast cancer surgery: meta-analysis. In: HTAI ANNUAL MEETING, June 24-28, 2023, Adelaide, Australia. Abstract... Edmonton, Alberta, Canada: Health Technology Assessment International, 2023. Disponível em: https://repositorio.ipen.br/handle/123456789/48956. Acesso em: 20 Mar 2026.
Esta referência é gerada automaticamente de acordo com as normas do estilo IPEN/SP (ABNT NBR 6023) e recomenda-se uma verificação final e ajustes caso necessário.