Patient satisfaction with Radioguided Occult Lesion Localisation using iodine-125 seeds ('ROLLIS') versus conventional hookwire localisation.

Jeremy S L Ong, Joelin Teh, Christobel Saunders, Anita G Bourke, Catalina Lizama, Jade Newton, Michael Phillips, Donna B Taylor

Journal: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology 2017;43(12):2261-2269

PMID: 29102440

Full Text on Elsevier Science View on PubMed

Abstract

BACKGROUND

Women with impalpable or poorly palpable breast cancer require radiologically guided localisation prior to breast conserving surgery. Radioguided Occult Lesion Localisation using Iodine-125 Seed (ROLLIS) is an emerging alternative to conventional Hookwire Localisation (HWL). We compared ROLLIS with conventional HWL with respect to patient reported stress and discomfort related to the localisation procedure.

PATIENTS AND METHODS

From September 2013 to January 2016, women who were eligible for breast conserving surgery with impalpable or poorly palpable histologically confirmed invasive or in-situ carcinoma were recruited to the multi-centre ROLLIS randomised controlled trial and underwent either ROLLIS or HWL. Following surgery, a questionnaire was administered to each participant regarding the stress and discomfort related to the localisation procedure. Multivariate analysis was performed to compare the primary outcome of patient-reported stress and discomfort between localisation groups.

RESULTS

218 participants with 220 lesions were randomised and underwent breast conserving surgery following localisation. 201 (92.2%) and 202 (92.7%) of participants provided responses to the stress and discomfort components of the questionnaire respectively. HWL was associated with a statistically significant increased odds of greater stress and discomfort when compared to ROLLIS (OR = 2.07, p = 0.01 and OR = 1.94, p = 0.01 respectively). Insertion of multiple localisation devices was also associated with increased stress (OR = 5.68, p < 0.01) and discomfort (OR = 2.96, p < 0.01).

CONCLUSION

When compared with conventional HWL, ROLLIS is associated with significantly less stress and discomfort for patients prior to breast conserving surgery.

Address: Department of Radiology, Sir Charles Gairdner Hospital, Nedlands, Western Australia 6009, Australia; Department of Medical Imaging, Fiona Stanley Hospital, Murdoch, Western Australia 6150, Australia; Department of Radiology, Royal Perth Hospital, Perth, Western Australia 6000, Australia. Electronic address: [email protected].; Department of Radiology, Sir Charles Gairdner Hospital, Nedlands, Western Australia 6009, Australia; Department of Medical Imaging, Fiona Stanley Hospital, Murdoch, Western Australia 6150, Australia; Department of Radiology, Royal Perth Hospital, Perth, Western Australia 6000, Australia. Electronic address: [email protected].; Medical School, Division of Surgery, University of Western Australia, Nedlands, Western Australia 6009, Australia; Department of Surgery, Royal Perth Hospital, Perth, Western Australia 6000, Australia; Department of Surgery, Fiona Stanley Hospital, Murdoch, Western Australia 6150, Australia. Electronic address: [email protected].; Department of Radiology, Sir Charles Gairdner Hospital, Nedlands, Western Australia 6009, Australia; Medical School, Division of Surgery, University of Western Australia, Nedlands, Western Australia 6009, Australia. Electronic address: [email protected].; Medical School, Division of Surgery, University of Western Australia, Nedlands, Western Australia 6009, Australia. Electronic address: [email protected].; Medical School, Division of Surgery, University of Western Australia, Nedlands, Western Australia 6009, Australia. Electronic address: [email protected].; Harry Perkins Institute for Medical Research, Perth, Western Australia 6000, Australia; Centre for Medical Research, University of Western Australia, Nedlands, Western Australia 6009, Australia. Electronic address: [email protected].; Department of Radiology, Royal Perth Hospital, Perth, Western Australia 6000, Australia; Medical School, Division of Surgery, University of Western Australia, Nedlands, Western Australia 6009, Australia. Electronic address: [email protected].

DOI: 10.1016/j.ejso.2017.09.021

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MeSH Terms: Breast Neoplasms, Female, Fiducial Markers, Humans, Iodine Radioisotopes, Mastectomy, Segmental, Middle Aged, Patient Satisfaction, Radionuclide Imaging, Reproducibility of Results, Sensitivity and Specificity, Surveys and Questionnaires, Treatment Outcome