Assessing the Utilization of Preoperative Ultrasound Guided Skin Marking for Tumor Localization in Post-Neoadjuvant Breast Cancer - A Single-Centre Study

Abstract

Objective: This study compares the cost-effective use of ultrasound-guided skin surface marking (USGSSM) with wire-guided localization (WGL) for tumor localization in breast cancer surgery at Shalamar Hospital.
Materials and Methods: A retrospective study was conducted at Shalamar Hospital, Lahore, between July 2023 and December 2023. The records of breast cancer patients including age, localization technique, sonographic and pathological tumor size, histologic type/grade, margin status, chemotherapy, and axillary dissection were included for analysis (27 WGL, 38 USGSSM). USGSSM involved preoperative surface marking in surgical position using ultrasound; WGL used ultrasound-guided wire insertion, confirmed with post-wire mammography. The data were entered and analyzed using SPSS version 25.
Results: The mean age of patients was 49 years, with invasive ductal carcinoma being most common. Mean ultrasound tumor size: WGL 13mm, USGSSM 17.7mm; mean pathological size: WGL 15.7mm, USGSSM 27.7mm. A significant correlation noted between ultrasound and pathological tumor sizes was noted (p < 0.001). Margins were involved in 6 cases (WGL: 2, USGSSM: 4), with no significant difference (p > 0.05).
Conclusion: USGSSM offers comparable efficacy to WGL for tumor margin clearance, making it a cost-effective option in breast-conserving surgery following neoadjuvant chemotherapy.