The role of radioactive iodine-125 seed localization in breast-conserving therapy following neoadjuvant chemotherapy
Menée sur 85 patientes atteintes d'un cancer du sein et ayant reçu entre janvier 2009 et décembre 2010 un traitement conservateur après chimiothérapie néoadjuvante, cette étude évalue, du point de vue de la réponse tumorale complète et de la qualité des marges de résection, l'intérêt des grains d'iode 125 pour localiser avec précision une tumeur mammaire unifocale ou multifocale
Background 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.Patients and methods 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.Results 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).Conclusions 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%.
Annals of Oncology , résumé, 2012