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US-guided Clip Implantation for Tumor Localization in
Breast Cancer Patients Who Undergo Neoadjuvant
Chemotherapy: Feasibility Study |
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Soo-Yeon Kim, MD1 Hee Jung Moon, MD, PhD1, Min Jung Kim, MD, PhD1,
Soo Hyun Lee, MD2, Eun-Kyung Kim, MD, PhD1 |
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1Department of Radiology and Research Institute of Radiological Science, Yonsei University
College of Medicine, Severance Hospital, Korea
2Department of Yonsei Cancer Center, Internal Medicine, Yonsei University College of
Medicine, Severance Hospital, Korea |
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Purpose: The purpose of our study was to investigate the feasibility of US-guided
clip implantation in patients receiving neoadjuvant chemotherapy for treatment of
breast cancer.
Materials and Methods: From January to May 2012, marker clips were inserted
with US guidance in or adjacent to 23 tumors in 20 female patients receiving neoadjuvant
chemotherapy for treatment of breast cancer at our institution. One radiologist
performed a retrospective review of the identification of tumors on US, mammography,
and breast MRI, and MRI artifact caused by a marker clip. Clip migration was
evaluated using the clip-to-nipple distance on mammography obtained immediately
after clip insertion and within one week before breast surgery. Complication associated
with clip insertion was also observed.
Results: After completion of neoadjuvant chemotherapy, all tumors showed a
decrease in size, and 13 of 23 (56.5%) tumors were no longer palpable and thus
required preoperative localization. In addition, marker clips were the only remaining
evidence of the original tumor site in three of 23 (13.0%) tumors at the time of preoperative
localization. All signal voids caused by a marker clip on breast MRI were less
than 1 cm, which did not have a significant effect on detection and evaluation of the
extent of the breast cancer. The mean change of the clip-to-nipple distance was 2.11
mm on a craniocaudal, and 2.67 mm on a mediolateral mammogram. No complication
associated with clip insertion was observed in any case.
Conclusion: US-guided clip implantation in or adjacent to a breast cancer is safe
and feasible for patients with anticipation of complete or near complete response to
neoadjuvant chemotherapy. |
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Keyword : Breast cancer; Neoadjuvant chemotherapy; Clip; Ultrasonography; Breast MRI |
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pdf파일 : 51-58김수연19.pdf
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