Clip and Blue—An Easy and Cost-Effective Prechemotherapy Localization Technique in Patients With Breast Cancer Planned for Breast Conservation
PURPOSEBreast conservation after systemic therapy requires accurate localization of the lesion and its margins, especially in nonpalpable tumors. The present study aims to describe a cost-effective technique of tumor localization using the combination of surgical clips and methylene blue.METHODSA mi...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
American Society of Clinical Oncology
2024-11-01
|
| Series: | JCO Global Oncology |
| Online Access: | https://ascopubs.org/doi/10.1200/GO-24-00242 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846151104839024640 |
|---|---|
| author | Teena Sleeba Subi TS Latha Abraham Sanju Cyriac Arun Philip Aswin Joy Anju Prathap Naveen George Susan John Anand Ebin Thomas |
| author_facet | Teena Sleeba Subi TS Latha Abraham Sanju Cyriac Arun Philip Aswin Joy Anju Prathap Naveen George Susan John Anand Ebin Thomas |
| author_sort | Teena Sleeba |
| collection | DOAJ |
| description | PURPOSEBreast conservation after systemic therapy requires accurate localization of the lesion and its margins, especially in nonpalpable tumors. The present study aims to describe a cost-effective technique of tumor localization using the combination of surgical clips and methylene blue.METHODSA minimum of three or four clips were inserted into the tumor to allow easy visualization of the clip mass. After insertion, measurements of the clips from the nipple and pectoral muscles were recorded to assess for clip migration. After chemotherapy, the disease and clip mass were localized intra-operatively using blue dye. A single-center review of breast conservations performed after neoadjuvant chemotherapy that used the above-described localization technique was undertaken. The primary aim was to assess successful detection and margin-negative resection rates.RESULTSThe study included 65 patients, and the clip mass was detected on ultrasound following chemotherapy in all patients without clip migration. This detection was accurate even in cases of complete pathological and radiological response. Importantly, there were no procedure-related complications. Postchemotherapy disease localization was successfully achieved in all patients using the readily available and cost-effective methylene blue dye. No patient had an invasive margin positive at resection.CONCLUSIONThe combination of using multiple surgical clips and methylene blue is not only an extremely cheap and accurate technique for tumor site localization but also ensures precise surgical removal. The technique allows tumor localization even in low-income economies. |
| format | Article |
| id | doaj-art-54eed9dfc33642f28e1fdc3d2368509e |
| institution | Kabale University |
| issn | 2687-8941 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | American Society of Clinical Oncology |
| record_format | Article |
| series | JCO Global Oncology |
| spelling | doaj-art-54eed9dfc33642f28e1fdc3d2368509e2024-11-27T20:59:11ZengAmerican Society of Clinical OncologyJCO Global Oncology2687-89412024-11-011010.1200/GO-24-00242Clip and Blue—An Easy and Cost-Effective Prechemotherapy Localization Technique in Patients With Breast Cancer Planned for Breast ConservationTeena Sleeba0Subi TS1Latha Abraham2Sanju Cyriac3Arun Philip4Aswin Joy5Anju Prathap6Naveen George7Susan John8Anand Ebin Thomas9Department of Radiodiagnosis, Rajagiri Hospital, Kochi, IndiaDepartment of Surgical Oncology, Rajagiri Cancer Centre, Rajagiri Hospital, Kochi, IndiaDepartment of Pathology, Rajagiri Cancer Centre, Rajagiri Hospital, Kochi, IndiaDepartment of Medical Oncology, Rajagiri Cancer Centre, Rajagiri Hospital, Kochi, IndiaDepartment of Medical Oncology, Rajagiri Cancer Centre, Rajagiri Hospital, Kochi, IndiaDepartment of Medical Oncology, Rajagiri Cancer Centre, Rajagiri Hospital, Kochi, IndiaDepartment of Surgical Oncology, Rajagiri Cancer Centre, Rajagiri Hospital, Kochi, IndiaDepartment of Surgical Oncology, Rajagiri Cancer Centre, Rajagiri Hospital, Kochi, IndiaDepartment of Clinical Epidemiology, Rajagiri Hospital, Kochi, IndiaDepartment of Surgical Oncology, Rajagiri Cancer Centre, Rajagiri Hospital, Kochi, IndiaPURPOSEBreast conservation after systemic therapy requires accurate localization of the lesion and its margins, especially in nonpalpable tumors. The present study aims to describe a cost-effective technique of tumor localization using the combination of surgical clips and methylene blue.METHODSA minimum of three or four clips were inserted into the tumor to allow easy visualization of the clip mass. After insertion, measurements of the clips from the nipple and pectoral muscles were recorded to assess for clip migration. After chemotherapy, the disease and clip mass were localized intra-operatively using blue dye. A single-center review of breast conservations performed after neoadjuvant chemotherapy that used the above-described localization technique was undertaken. The primary aim was to assess successful detection and margin-negative resection rates.RESULTSThe study included 65 patients, and the clip mass was detected on ultrasound following chemotherapy in all patients without clip migration. This detection was accurate even in cases of complete pathological and radiological response. Importantly, there were no procedure-related complications. Postchemotherapy disease localization was successfully achieved in all patients using the readily available and cost-effective methylene blue dye. No patient had an invasive margin positive at resection.CONCLUSIONThe combination of using multiple surgical clips and methylene blue is not only an extremely cheap and accurate technique for tumor site localization but also ensures precise surgical removal. The technique allows tumor localization even in low-income economies.https://ascopubs.org/doi/10.1200/GO-24-00242 |
| spellingShingle | Teena Sleeba Subi TS Latha Abraham Sanju Cyriac Arun Philip Aswin Joy Anju Prathap Naveen George Susan John Anand Ebin Thomas Clip and Blue—An Easy and Cost-Effective Prechemotherapy Localization Technique in Patients With Breast Cancer Planned for Breast Conservation JCO Global Oncology |
| title | Clip and Blue—An Easy and Cost-Effective Prechemotherapy Localization Technique in Patients With Breast Cancer Planned for Breast Conservation |
| title_full | Clip and Blue—An Easy and Cost-Effective Prechemotherapy Localization Technique in Patients With Breast Cancer Planned for Breast Conservation |
| title_fullStr | Clip and Blue—An Easy and Cost-Effective Prechemotherapy Localization Technique in Patients With Breast Cancer Planned for Breast Conservation |
| title_full_unstemmed | Clip and Blue—An Easy and Cost-Effective Prechemotherapy Localization Technique in Patients With Breast Cancer Planned for Breast Conservation |
| title_short | Clip and Blue—An Easy and Cost-Effective Prechemotherapy Localization Technique in Patients With Breast Cancer Planned for Breast Conservation |
| title_sort | clip and blue an easy and cost effective prechemotherapy localization technique in patients with breast cancer planned for breast conservation |
| url | https://ascopubs.org/doi/10.1200/GO-24-00242 |
| work_keys_str_mv | AT teenasleeba clipandblueaneasyandcosteffectiveprechemotherapylocalizationtechniqueinpatientswithbreastcancerplannedforbreastconservation AT subits clipandblueaneasyandcosteffectiveprechemotherapylocalizationtechniqueinpatientswithbreastcancerplannedforbreastconservation AT lathaabraham clipandblueaneasyandcosteffectiveprechemotherapylocalizationtechniqueinpatientswithbreastcancerplannedforbreastconservation AT sanjucyriac clipandblueaneasyandcosteffectiveprechemotherapylocalizationtechniqueinpatientswithbreastcancerplannedforbreastconservation AT arunphilip clipandblueaneasyandcosteffectiveprechemotherapylocalizationtechniqueinpatientswithbreastcancerplannedforbreastconservation AT aswinjoy clipandblueaneasyandcosteffectiveprechemotherapylocalizationtechniqueinpatientswithbreastcancerplannedforbreastconservation AT anjuprathap clipandblueaneasyandcosteffectiveprechemotherapylocalizationtechniqueinpatientswithbreastcancerplannedforbreastconservation AT naveengeorge clipandblueaneasyandcosteffectiveprechemotherapylocalizationtechniqueinpatientswithbreastcancerplannedforbreastconservation AT susanjohn clipandblueaneasyandcosteffectiveprechemotherapylocalizationtechniqueinpatientswithbreastcancerplannedforbreastconservation AT anandebinthomas clipandblueaneasyandcosteffectiveprechemotherapylocalizationtechniqueinpatientswithbreastcancerplannedforbreastconservation |