Stereotactic radioguided surgery by siteSelect for subclinical mammographic lesions

• Published in: Annals of surgical oncology 2005-02, Vol.12 (2), p.181-188
• Main Authors: Doridot, Virginie, Meunier, Martine, El Khoury, Carl, Nos, Claude, Vincent-Salomon, Anne, Sigal-Zafrani, Brigitte, Clough, Krishna B
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biopsy, Needle; Breast - pathology; Breast - surgery; Breast Diseases - pathology; Breast Diseases - surgery; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Feasibility Studies; Female; Humans; Mastectomy, Segmental; Middle Aged; Prospective Studies; Stereotaxic Techniques - instrumentation
• ISSN: 1068-9265; 1534-4681
• DOI: 10.1245/ASO.2005.01.004

We defined the indications for and evaluated the results of a new technique for radioguided surgery, the SiteSelect system. The procedure allows en-bloc resection of the breast parenchyma under local anesthesia. This prospective study was based on 167 patients operated on between December 2000 and October 2003 with 2 phases. The first step was an evaluation of the feasibility of the procedure with the 15-mm cannula, and the second was therapeutic with the 22-mm cannula. The mean duration of the procedure was 42 minutes. In 96.9% of procedures, the lesion was excised successfully. Only one complication (hematoma) and two failures and were observed. Histological examination revealed benign disease in 65.8% of cases and cancer in 34.2% of cases. In the latter cases, the specimen margins were histologically involved in 86.2% of cases with the 15-mm procedure and in 41% with the 22-mm procedure. During the first evaluation, all patients with a cancer underwent systematic surgical re-excision: residual tumor was present in 18 cases (64.2%). The biopsy was painless for 88 patients, and the cosmetic result was good in all cases. This study shows that the SiteSelect procedure allows resection of the lesion in 96.9% of cases. Combined with complementary surgical lumpectomy during the same operation, this procedure achieved a success rate of 98.7%. In the case of cancer, the 15-mm cannula is not wide enough to allow free margins. The use of a new 22-mm cannula, currently under evaluation, might solve this problem.