A cosmesis outcome substudy in a prospective, randomized trial comparing radioguided seed localization with standard wire localization for nonpalpable, invasive, and in situ breast carcinomas

Elena Parvez, Sylvie D Cornacchi, Nicole Hodgson, Achilleas Thoma, Iwa Kong, Gary Foster, Ji Cheng, Charlie H Goldsmith, Dyda Dao, Peter J Lovrics
American Journal of Surgery 2014, 208 (5): 711-718

BACKGROUND: The primary study objective was to compare the cosmetic result of radioguided seed localization (RSL) with wire localization (WL).

METHODS: A subgroup of patients enrolled in a multicentered, randomized trial comparing WL with RSL participated. Frontal photographs were taken 1 and 3 years postsurgery. The European Organization for Research and Treatment of Cancer Cosmetic Rating System was used to evaluate cosmesis outcomes by the patient and a panel of 5 raters.

RESULTS: The study enrolled 73 patients (WL, n = 38; RSL, n = 35). Most patients rated their overall cosmesis as "excellent" or "good" (76% WL, 80% RSL). Patient and panel ratings on all cosmetic outcomes were similar between groups. Multivariable regression for overall cosmesis found larger specimen volume and reoperation to be predictors of worse ratings.

CONCLUSIONS: All cosmetic outcomes assessed were similar after WL and RSL. The comparable outcomes may reflect similar reoperation rates and volumes of excision between groups.

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