Preoperative localization of nonpalpable breast cancer using clip insertion and skin marking: a prospective controlled study

Background Many cases of breast cancer are detected at early stages mainly due to the adoption of screening programs and the increase of public awareness about breast cancer. This requires preoperative localization of the mass for adequate excision and precise planning for breast-conservative surgery. The aim of this study was to demonstrate noninferiority of preoperative ultrasound-guided clipping with skin marking of nonpalpable breast lesions for obtaining negative surgical margins. Patients and methods Fifty patients diagnosed with nonpalpable breast cancer, were recruited for the study and were compared with the last 50 correlated patients in the database, who underwent wide local excision of their lesions under wire-guiding as regards the surgical margins assessed by intraoperative frozen section technique. Results Free surgical margin was achieved in 47/50 patients when 'sonographic' skin marking and clip application was applied. Level-I oncoplasty was done to all the 50 patients in the study group as well as those retrieved from the database. Conclusion Omitting the application of wire for nonpalpable breast lesions and replacing it with skin marking is feasible and cost-effective.