The role of radioactive iodine-125 seed localization in breast-conserving therapy following neoadjuvant chemotherapy

• Published in: Annals of oncology Vol. 24; no. 3; pp. 668 - 673
• Main Authors: Gobardhan, P.D., de Wall, L.L., van der Laan, L., ten Tije, A.J., van der Meer, D.C.H., Tetteroo, E., Poortmans, P.M.P., Luiten, E.J.T.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-03-2013; Oxford University Press
• Subjects: Aged; Antineoplastic agents; Biological and medical sciences; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - therapy; breast-conserving therapy; Carcinoma, Ductal, Breast - diagnostic imaging; Carcinoma, Ductal, Breast - therapy; Chemotherapy, Adjuvant; Female; Humans; Injections, Intralesional; Iodine Radioisotopes - administration & dosage; iodine seed localization; Mastectomy, Segmental - methods; Medical sciences; Middle Aged; neoadjuvant chemotherapy; Neoadjuvant Therapy; Pharmacology. Drug treatments; Radionuclide Imaging; Radiopharmaceuticals - administration & dosage; Treatment Outcome; breast-conserving therapy; neoadjuvant chemotherapy; iodine seed localization; Chemotherapy; Treatment; Seeds; Breast; Mammary gland; Radioisotope; Localization; Neoadjuvant treatment
• ISSN: 0923-7534; 1569-8041
• DOI: 10.1093/annonc/mds475

Neoadjuvant chemotherapy (NAC) is increasingly used in the framework of breast-conserving therapy (BCT). Localization of the initial tumor is essential to guide surgical resection after NAC. This study describes the results obtained with I-125 seed localization in BCT including NAC.
Between January 2009 and December 2010, 85 patients treated with NAC and BCT after I-125 seed localization were included. Radiological and pathological response and resection margins were retrospectively evaluated.
BCT was carried out in 85 patients without secondary local excisions. Nineteen patients with unifocal tumors and seven patients with multifocal tumors showed a complete pathological response (P = 0.18). Tumor-free resection margins were obtained in 78 patients (50 patients with unifocal and 28 patients with multifocal tumors, P = 0.27). Focally involved margins were found in four patients (two patients with a unifocal and two patients with a multifocal tumor, P = 0.27). A subsequent mastectomy was carried out in three patients (two patients with multifocal tumors, P = 0.29).
BCT after NAC can be carried out successfully after initial localization with I-125 seeds in both unifocal and multifocal breast tumors with complete resection rates of >90%.