Efficacy of localization of non-palpable, invasive breast cancer: Wire localization vs. Iodine-125 seed: A historical comparison

Background: To achieve radical tumour excision in non-palpable breast cancer accurate tumour localization is essential. Historically, this has been achieved by wire localization (WL). Recently, new techniques like Iodine-125 seeds (IL) have become available. The aim of this study was to determine whether the results in case of IL are better than when WL is used. Method: A consecutive series of patients operated on because of don-palpable breast cancer was analysed. Between January 2007 and April 2011 WL was method of choice. From April 2011 till January 2013 IL was introduced and became the standard procedure. Primary outcomes were: success rate of (peri-) operative localization and radicality of the excision. Secondary outcomes were duration of operation and volumes of the excised tissue specimen. Results: A total of 236 women were included; 149 women underwent WL and 87 women IL. The overall success rate for WL was 93.3%. In 10 patients (6.7%) WL failed because of peri-operative dislocation of the wire compared to only one failure to locate the seed in de postoperative specimen in the IL-group (1.1%, p = 0.098). Radical resection was obtained in 126/149 (84.6%) of the WL-patients, in comparison with 81/87 (93.1%) in the IL-group (p = 0.054). Median operation time and volume of the specimen was not significantly different between both groups. Conclusion: Localization of non-palpable breast cancer using Iodine-125 seeds is, at least, as good as the standard wire localization procedure.