• Laura Niinikoski, Katja Hukkinen, LeideniusMarjut H KMHKBreast Surgery Unit, Comprehensive Cancer Center, University of Helsinki, Helsinki University Hospital Finland, P.O. Box 263, 00029, HUS, Finland., Päivi Vaara, Aleksandar Voynov, Päivi Heikkilä, Johanna Mattson, and Tuomo J Meretoja.
• Breast Surgery Unit, Comprehensive Cancer Center, University of Helsinki, Helsinki University Hospital Finland, P.O. Box 263, 00029, HUS, Finland. Electronic address: laura.niinikoski@hus.fi.
• Breast. 2019 Oct 1; 47: 93-101.

ObjectivesThe aim of this retrospective study is to compare surgical margins, reoperation rates and local recurrences after breast conserving surgery (BCS) using radioguided occult lesion localization (ROLL) or radioactive seed localization (RSL).Materials And MethodsWe reviewed 744 consecutive patients with impalpable primary invasive breast cancer who underwent BCS at Helsinki University Hospital between 2010 and 2012. ROLL was used in our unit until October 31st, 2011; from November 1st we changed localization method to RSL.Results318 patients underwent ROLL and 426 RSL. Patients in the RSL group had more often multifocal (p = 0.013) tumours. No statistically significant differences were found regarding tumour size, specimen weight, histology or grade of tumours or lymph node status. 42 (5.6%) patients were reoperated because of insufficient margins, 13 (4.1%) in the ROLL group and 29 (6.8%) in the RSL group. The reoperation rate was not different between the groups either in the univariable analysis (p = 0.112) or in the multivariable binary logistic regression analysis (p = 0.204). Risk factors for reoperations were multifocality of the tumour (p < 0.001), extensive intraductal component (p < 0.001), larger tumour size (p = 0.011), and smaller specimen weight (p = 0.014). The median follow-up time in the ROLL group was 81 (8-94) months and 64 (3-73) months in the RSL group. The five-year local recurrence-free survival (LRFS) estimates for ROLL and RSL groups were 98.0% and 99.4%, respectively (log-rank test, p = 0.323).ConclusionReoperation rates and LRFS were comparable for ROLL and RSL in patients with impalpable breast cancer treated with BCS.Copyright © 2019 Elsevier Ltd. All rights reserved.

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