To assess the clinical usefulness of radio-opaque marker insertion into malignant breast tumours in patients undergoing neo-adjuvant chemotherapy prior to consideration of breast-conserving surgery

Introduction

The study looks at our experience in the first 29 patients who were referred for marker insertion.

Method

The markers were all placed by a radiologist under ultrasound guidance into the central area of the tumour. The technique is described.

Results

Of the 26 patients who had a successful marker placement, 23 went on to have a good response to chemotherapy. In 15 of these the tumour was no longer clinically palpable. These patients underwent standard wire localisation with the hook of the wire placed into the 'tumour bed' using either stereotactic mammographic guidance focusing on the implanted marker (11 patients) or using ultrasound guidance if the tumour was still visible on ultrasound (four patients). This enabled the surgeon to perform a wide local excision centred on the 'marked' tumour bed even though it was no longer palpable.

Conclusion

We conclude that the insertion of the radio-opaque markers into breast tumours is a useful aid to guide breast-conserving surgery following neo-adjuvant chemotherapy. These initial results require validation by larger scale studies.