10 Wire Localization vs Radar Reflector Localization: A Comparison

Background

Image-guided localization is a standard component of breast-conserving surgery (BCS) for nonpalpable malignancies. Although wire localization (WL) is the most widely used approach, several nonwire methods are available. Some newer localization methods purport superiority in optimizing adequate margins. We compared traditional wire localization with radar reflector localization (RRL) over 1 year to evaluate differences in margin status and lumpectomy to tumor size ratio (LTTSR).

Methods

Retrospective review of patients treated with BCS using image-guided localization for stage 0-II breast cancer at Christiana Care Health System (CCHS) in 2021. Patients identified from the CCHS tumor registry were stratified by localization method (WL vs RRL) Pearson χ2 or Fisher exact statistical analysis was performed comparing combined positive margin (PM, tumor on ink) and, in cases of pure ductal carcinoma in-situ (DCIS), close margin (CM, tumor ≤2 mm from margin) rates between WL and RRL groups. LTTSR was defined as the largest dimension of the primary lumpectomy specimen divided by the largest tumor dimension. Median LTTSR for each group was compared using Mann-Whitney U test. A P-value of ≤0.05 was significant.

Results

259 patients (180 WL and 79 RRL). PM/CM rate for the entire cohort: 21.2%. No statistical difference in PM/CM rates between WL and RRL for invasive cancer or DCIS. No significant difference in the LTTSR between the 2 localization techniques.

Conclusions

We conclude that RRL and WL are equivalent localization techniques for invasive breast cancer and DCIS, yielding similar rates of adequate excision and specimen sizes.

AFFILIATIONS:

Karisa Beebe,¹ Elissa Dalton,¹ Candice Ford,¹ Lianteng Zhi,¹ Karen Louie,¹ Dawn J. Leonard,¹ Dennis Witmer,¹ Christopher Verdone,¹ Jennifer Sims Mourtada,¹ Valerie L. Staradub¹

¹Christiana Care, Newark, DE.