Sunny D. Mitchell, MD1; Brie Fantini, PA-C1; Rathbun C, Lee H
1Montefiore Nyack Hospital, Nyack, NY.
Background
To facilitate postoperative radiation therapy and radiographic follow-up of their patients, surgeons are challenged in achieving the conceptually simple task of adequately marking the tumor bed during breast conservation surgery (BCS). The ideal marker safely features the trinity of accuracy, comfort, and speed. Such a marker is nonpalpable, deployed easily and quickly independent of the type of BCS or breast characteristics, permits unimpeded reapproximation of tissue, and preserves the exact location of the true tumor bed.
Materials and Methods
VFilM-A (Verifiable Filament Marker) is an institutional review board–approved, observational retrospective registry of a radiographically verifiable filament marker, VeraForm®. During BCS, the marker was deployed to delineate only the tumor bed. This analysis evaluates patient, breast, and surgical characteristics. The cases include oncoplastic (OP) and nononcoplastic (non-OP) BCS. Breast size and tumor location were not factors in case selection. All patients received routine care and follow-up in accordance with national guidelines (National Comprehensive Cancer Network, American Society for Radiation Oncology, American Society of Breast Surgeons, American Society for Clinical Oncology).
Results
Fifty consecutive patients had 51 BC surgeries for ductal carcinoma in situ or invasive cancer (Table).
Conclusions
Tumor bed marking was performed in 2 minutes or less under direct visualization while utilizing a variety of OP and non-OP surgical techniques via a wide range of incisions on a wide range of breast characteristics. No pain, palpability, or infections were noted. No effect on cosmesis was noted by patients or surgeons.