A Comparative Study between Two Localization Methods for Breast Cancer Prior to Neoadjuvant Chemotherapy

Abstract Background: The key to surgical planning for breast conservative surgery (BCS) after neoadjuvant chemotherapy (NAC) is tumor localization. Tumor marking can be done using different methods. Aim of Study: The objective of this study was to compare two localization methods before initiation of NAC; a new cost-effective method using sterile silver rods versus the standard commercial titanium clip to assess if this novel cheap technique can be popularized in low-resource countries. Patients and Methods: This retrospective comparative study was conducted on breast cancer patients admitted to oncology centre Mansoura University between May 2018 and April 2021. All patients have received NAC followed by surgery as recommended by our multi-disciplinary team (MDT). All the patients had a primary operable solitary breast cancer. Forty breast cancer patients were included; divided into 2 groups; 20 patients had titanium clip (group 1) and the other twenty had silver markers (group 2) before starting chemotherapy. Results: Median clinical tumor size was 4.65±1.6cm in group 1 and 4.3±1.8cm in group 2 (p=0.206). After NAC treatment, there were no statistically significant differences in both groups regarding clinical and pathological responses. Median pathological tumor size was 1.8±1.4cm in group 1 and 1.6±1.2cm in group 2 (p=0.671). Median excised breast volume was larger in group 2 (220 g) than group 1 (110g); p<0.001. There were no reported major complications in both groups. Marker visibility and excision were easy in both groups. There were no statistically significant differences when comparing margin status and local recurrence rate. Conclusion: Marking the tumor marginsby sterile silver markers before initiation of neoadjuvant chemotherapy is comparable to the commercial titanium clip with much lower cost.