Comparison of breast tissue markers for tumor localization in breast cancer patients undergoing neoadjuvant chemotherapy.
Ja Ho Koo, Min Jung Kim, Eun-kyung Kim, Hee Jung Moon, Jung Hyun Yoon, Vivian Youngjean Park
Yonsei University College of Medicine, Seoul , Korea
Corresponding Author: Min Jung Kim ,Tel: 82222287400, Fax: 8223933035, Email: mines@yuhs.ac
Received: January 8, 2019;  Accepted: April 7, 2019.  Published online: April 7, 2019.
ABSTRACT
Purpose:
To compare the visibility of breast tissue markers within breast cancer on ultrasound (US) after neoadjuvant chemotherapy (NAC) and to analyze whether the type of marker has an effect on choosing localization methods after NAC.
Methods:
We included 153 tissue markers inserted within breast cancers with pathologically complete response (pCR) after NAC from January 2012 to April 2017. One of three types of marker (surgical clip, Cormark™, and UltraClip®) was inserted. Medical records and imaging findings were retrospectively reviewed. We compared the visibility of the different types of tissue marker on US after NAC, and also compared the imaging modalities used in preoperative localization. The Chi-square test, Fisher’s exact test and multiple logistic regression were used for analysis.
Results:
Of the 153 tissue markers, 56 were surgical clips, 61 Cormark™, and 36 UltraClip®. After NAC, residual lesions were not seen on US in 42 cases (27.5%). In multivariate analysis, the visibility of the surgical clip or Cormark™ was better than UltraClip® (OR (95% confidence interval, p-value) was 5.467 (1.717-17.410, 0.004), 3.045 (1.074-8.628, 0.036), respectively). Among the 131 cases where localization targeting the marker was required, the proportion of US-guided localization being performed was significantly higher when using the surgical clip than UltraClip® (OR (95% confidence interval, p-value) was 5.566 (1.610-19.246, 0.007)) in multivariate analysis.
Conclusion:
The type of breast tissue marker affects its visibility on US in cases with pCR after NAC which in turn affects the localization methodology.
Keywords: Breast neoplasms; Ultrasonography; Breast localization; Breast marker
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