Background: Accurate peri-operative localisation of breast tumours is an important component of breast conserving surgery. While radiologically inserted hook-wires have been the cornerstone of breast localisation for many years, newer techniques are now available. Some of these techniques have several advantages over traditional wire-guided procedures, including greater flexibility in terms of when the localisation procedure can be performed prior to the patients operation, avoiding the need for radiology support on the day of surgery. Our unit have recently adopted the use of the Hologic® LOCalizer™ as our localisation technique of choice and present our initial data and experience of the technique here. Materials and methods: Data from all patients who underwent a localised wide local excision using the Hologic® LOCalizer™ device was collected over the initial 6 months immediately after obtaining the equipment. Data collected included: patient demographics, BMI, indication for surgery, pre-operative radiological findings, tumour characteristics, pathological margins and postoperative complications. Results: A total of 54 patients underwent surgery using the Hologic® LOCalizer™ during the study time-frame (January–June 2021). The median patient age was 62 years (37–73 years), mean BMI was 30.1Kg/m² (21– 41Kg/m²) and the majority of patients had lesions detected through breast screening (n = 33, 61%). Most patients were undergoing surgery for an invasive breast cancer (n = 44, 81%) and the mean tumour size detected via mammogram and ultrasound was 16.5 mm (4–62 mm) and 11.6 mm (4– 58 mm) respectively. The RFID was inserted an average of 12 days prior to the patients surgery (0–44 days) and circumferential excision margins were complete (>1 mm) in 86% (n = 57) of cases. Complications following surgery occurred in 5 patients (7%), primarily due to post-operative wound infection (n = 3, 4%). In 2 cases, the RFID TAG was dislodged during the surgical procedure, although successful surgical excision of the lesion was still possible. In both cases the TAG was placed superficially within the breast and was also placed on the same day as the patients surgery. Conclusions: The Hologic® LOCalizer™ appears to be a safe and clinically valid alternative to wire-guided localisation of impalpable breast lesions. Despite the “learning curve” phenomenon associated with the use of any new technique, post-operative results appear satisfactory in terms of an acceptable complication and re-excision rate, despite the patient population being of higher than average BMI. Caution should however be taken when using the technique to localise lesions deep within the breast of patients with a higher than average BMI and the authors would also recommend avoiding RFID TAG placement on the day of surgery itself, to minimise the risk of TAG displacement during the surgical procedure. No conflict of interest. 

Alternative breast cancer localisation techniques in Wales: an early experience

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Alternative breast cancer localisation techniques in Wales: an early experience