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Article: The Evolving Role of Radiofrequency Guided Localisation in Breast Surgery: A Systematic Review.

Tayeh, Salim / Wazir, Umar / Mokbel, Kefah

2021 Volume 13, Issue 19

Abstract: Wire-guided localisation (WGL) has been the gold-standard for localising non-palpable breast lesions before excision. Due to its drawbacks, various wireless alternatives have been developed, including LOCalizer™, which is based on radio-frequency ... ...

Abstract	Wire-guided localisation (WGL) has been the gold-standard for localising non-palpable breast lesions before excision. Due to its drawbacks, various wireless alternatives have been developed, including LOCalizer™, which is based on radio-frequency identification (RFID) technology. In this systematic review, we consulted EMBASE, Medline and PubMed databases using appropriate search terms regarding the use of RFID technology in the localisation of occult breast lesions. Retrospective and prospective studies were included if they quoted the number of patients, rate of successful placement, retrieval rate, margin positivity rate and the re-excision rate. In addition, studies comparing RFID to WGL were also included and analysed separately. Seven studies were included in this systematic review spanning 1151 patients and 1344 tags. The pooled deployment rate was 99.1% and retrieval rate was 100%. Re-excision rate was 13.9%. One complication was identified. Two studies compared RFID with WGL (128 vs. 282 patients respectively). For both techniques the re-excision rate was 15.6% (20/128 vs. 44/282 respectively,
Language	English
Publishing date	2021-10-05
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers13194996
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Is oncoplastic breast conserving surgery oncologically safe? A meta-analysis of 18,103 patients.

Kosasih, Sebastian / Tayeh, Salim / Mokbel, Kefah / Kasem, Abdul

American journal of surgery

2020 Volume 220, Issue 2, Page(s) 385–392

Abstract: Background: Oncoplastic Breast Conserving Surgery (OBCS) allows adequate resection margins of tumours unsuitable for standard breast conserving surgery (SBCS) whilst allowing for better cosmesis and reduced morbidity when compared to mastectomy. However, ...

Abstract	Background: Oncoplastic Breast Conserving Surgery (OBCS) allows adequate resection margins of tumours unsuitable for standard breast conserving surgery (SBCS) whilst allowing for better cosmesis and reduced morbidity when compared to mastectomy. However, there is limited evidence on its oncological safety. Methods: This study aims to compare oncological safety of OBCS with SBCS and mastectomy by examining the relative risk of cancer recurrence and re-operation rates through meta-analysis. Results: 18 studies met the search criteria including 18,103 patients. The primary outcome measure (recurrence) was not significantly different between OBCS and SBCS or mastectomy (RR 0.861; 95% CI 0.640-1.160; p = 0.296). The secondary outcome measure (re-operation) initially achieved significance in favour of OBCS (RR 0.64; 95% CI 0.46-0.89; p = 0.01). However, after adjustment for publication bias this was attenuated to insignificance between the two study groups (RR 0.86; 95% CI 0.56-1.31; p = 0.44). Conclusions: For both cancer recurrence and re-operation rate, there was no significant difference between OBCS and traditional techniques. OBCS is of comparable oncological safety to more established surgical procedures and a useful option in suitable patients.
MeSH term(s)	Breast Neoplasms/surgery ; Female ; Humans ; Mastectomy, Segmental/adverse effects
Language	English
Publishing date	2020-01-02
Publishing country	United States
Document type	Journal Article ; Meta-Analysis
ZDB-ID	2953-1
ISSN	1879-1883 ; 0002-9610
ISSN (online)	1879-1883
ISSN	0002-9610
DOI	10.1016/j.amjsurg.2019.12.019
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Article: The Evolving Role of Marked Lymph Node Biopsy (MLNB) and Targeted Axillary Dissection (TAD) after Neoadjuvant Chemotherapy (NACT) for Node-Positive Breast Cancer: Systematic Review and Pooled Analysis.

Swarnkar, Parinita K / Tayeh, Salim / Michell, Michael J / Mokbel, Kefah

Cancers

2021 Volume 13, Issue 7

Abstract: Targeted axillary dissection (TAD) is a new axillary staging technique that consists of the surgical removal of biopsy-proven positive axillary nodes, which are marked (marked lymph node biopsy (MLNB)) prior to neoadjuvant chemotherapy (NACT) in addition ...

Abstract	Targeted axillary dissection (TAD) is a new axillary staging technique that consists of the surgical removal of biopsy-proven positive axillary nodes, which are marked (marked lymph node biopsy (MLNB)) prior to neoadjuvant chemotherapy (NACT) in addition to the sentinel lymph node biopsy (SLNB). In a meta-analysis of more than 3000 patients, we previously reported a false-negative rate (FNR) of 13% using the SLNB alone in this setting. The aim of this systematic review and pooled analysis is to determine the FNR of MLNB alone and TAD (MLNB plus SLNB) compared with the gold standard of complete axillary lymph node dissection (cALND). The PubMed, Cochrane and Google Scholar databases were searched using MeSH-relevant terms and free words. A total of 9 studies of 366 patients that met the inclusion criteria evaluating the FNR of MLNB alone were included in the pooled analysis, yielding a pooled FNR of 6.28% (95% CI: 3.98-9.43). In 13 studies spanning 521 patients, the addition of SLNB to MLNB (TAD) was associated with a FNR of 5.18% (95% CI: 3.41-7.54), which was not significantly different from that of MLNB alone (
Language	English
Publishing date	2021-03-26
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers13071539
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Article ; Online: Evolving Role of Magseed in Wireless Localization of Breast Lesions: Systematic Review and Pooled Analysis of 1,559 Procedures.

Gera, Ritika / Tayeh, Salim / Al-Reefy, Sara / Mokbel, Kefah

Anticancer research

2020 Volume 40, Issue 4, Page(s) 1809–1815

Abstract: Background/aim: Wire-guided localisation (WGL) remains the most widely used technique for the localisation of non-palpable breast lesions; however, recent technological advances have resulted in non-wire, non-radioactive alternatives, such as magnetic ... ...

Abstract	Background/aim: Wire-guided localisation (WGL) remains the most widely used technique for the localisation of non-palpable breast lesions; however, recent technological advances have resulted in non-wire, non-radioactive alternatives, such as magnetic seeds (Magseeds). The aim of this pooled analysis was to determine whether Magseeds are an effective tool for localising non-palpable breast lesions. Materials and methods: Various databases were searched for publications which reported data on the localisation and placement rates of Magseed. Data on re-excision rates under use of Magseed and WGL were also collected. Results: Sixteen studies, spanning the insertion of 1,559 Magseeds, were analysed. The pooled analysis showed a successful placement rate of 94.42% and a successful localisation rate of 99.86%. Four studies were analysed in a separate pooled analysis and showed no statistically significant difference between re-excision rates using Magseeds and WGL. Conclusion: The use of Magseeds is an effective, non-inferior alternative to WGL that overcomes many of the limitations of the latter.
MeSH term(s)	Breast/pathology ; Breast/radiation effects ; Breast Neoplasms/epidemiology ; Breast Neoplasms/pathology ; Breast Neoplasms/therapy ; Female ; Humans ; Magnetic Field Therapy ; Magnetic Fields ; Magnetics ; Mastectomy, Segmental
Language	English
Publishing date	2020-03-31
Publishing country	Greece
Document type	Journal Article ; Meta-Analysis ; Review ; Systematic Review
ZDB-ID	604549-2
ISSN	1791-7530 ; 0250-7005
ISSN (online)	1791-7530
ISSN	0250-7005
DOI	10.21873/anticanres.14135
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Article ; Online: Locoregional therapy of the primary tumour in de novo stage IV breast cancer in 216 066 patients: A meta-analysis.

Gera, Ritika / Chehade, Hiba E L Hage / Wazir, Umar / Tayeh, Salim / Kasem, Abdul / Mokbel, Kefah

Scientific reports

2020 Volume 10, Issue 1, Page(s) 2952

Abstract: Patients presenting with de novo stage IV metastatic breast cancer have a complex disease which is normally treated with palliative intent and systemic therapy. However, there is mounting evidence that resection of the primary tumour and/or localised ... ...

Abstract	Patients presenting with de novo stage IV metastatic breast cancer have a complex disease which is normally treated with palliative intent and systemic therapy. However, there is mounting evidence that resection of the primary tumour and/or localised radiotherapy (locoregional therapy; LRT) could be associated with overall survival improvements. We aimed to conduct a meta-analysis to inform decision making. Using the PubMed, Cochrane and Ovid SP databases, a literature review and meta-analysis were conducted to assess the effect of LRT on overall survival. Studies were analysed for the impact of LRT on survival. All forms of LRT resulted in a significant 31.8% reduction in mortality (N = 42; HR = 0.6823 (95% CI 0.6365; 0.7314)). Surgical resection resulted in a significant 36.2% reduction in mortality (N = 37; HR = 0.6379 (95% CI 0.5974; 0.6811)). The prospective trials reported a 19.23% reduction in mortality which was not statistically significant (N = 3, HR = 0.8077 (95% CI 0.5704; 1.1438). 216 066 patients were included. This is the largest meta-analysis regarding this question to date. Our meta-analysis shows that LRT of the primary tumour seems to improve overall survival in de novo stage IV disease. Therefore, this therapeutic option should be considered in selected patients after a careful multidisciplinary discussion.
MeSH term(s)	Breast Neoplasms/pathology ; Breast Neoplasms/therapy ; Female ; Humans ; Neoplasm Staging ; Prognosis ; Prospective Studies ; Survival Analysis
Language	English
Publishing date	2020-02-19
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-020-59908-1
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Article ; Online: Wireless Breast Localization Using Radio-frequency Identification Tags: The First Reported European Experience in Breast Cancer.

Wazir, Umar / Tayeh, Salim / Perry, Nicholas / Michell, Michael / Malhotra, Anmol / Mokbel, Kefah

In vivo (Athens, Greece)

2020 Volume 34, Issue 1, Page(s) 233–238

Abstract: Background/aim: Wire-guided localisation (WGL) has been the mainstay for localisation of clinically occult breast lesions before excision. However, it has restrictive scheduling requirements, and causes patient discomfort. This has prompted the ... ...

Abstract	Background/aim: Wire-guided localisation (WGL) has been the mainstay for localisation of clinically occult breast lesions before excision. However, it has restrictive scheduling requirements, and causes patient discomfort. This has prompted the development of various wireless alternatives. In this prospective study we shall evaluate the role of radiation-free wireless localisation using a radiofrequency identification (RFID) tag and a hand-held reader (LOCalizer™) in the management of occult breast lesions. Patients and methods: This technique was evaluated in a prospective cohort of 10 patients. The evaluation focused on: i) successful deployment, ii) identification and retrieval, iii) the status of surgical margins and need for re-operation, iv) resected specimen weight, v) marker migration rates (>5mm), and vi) acceptance by patients, radiologists and surgeons. Results: RFID tags (n=11) were deployed under ultrasound guidance pre-operatively to localise occult breast lesions in 10 patients. The mean time for deployment of the RFID tag was 5.4 min (range=2-20). The mean distance from the lesion was 0.45 mm (range=0-3). The mean duration for retrieval was 10.2 min (range=6-20). Mean specimen weight was 19.6 g for malignant lesions (range=4.5-42). All tags were identified, and none had migrated. There were no positive margins, re-operations, nor complications. Patient feedback was highly positive. Both radiologists and surgeons rated the LOCalizer™ technique as better than WGL. Conclusion: Our study demonstrates that wireless localisation using RFID is an effective and time-efficient alternative to WGL, with low margin positivity and re-operation rates, and high patient, radiologist and surgeon acceptance.
MeSH term(s)	Adult ; Aged ; Breast Neoplasms/diagnosis ; Breast Neoplasms/surgery ; Female ; Humans ; Middle Aged ; Prognosis ; Prospective Studies ; Radio Frequency Identification Device/methods ; Wireless Technology/instrumentation
Language	English
Publishing date	2020-01-13
Publishing country	Greece
Document type	Journal Article
ZDB-ID	807031-3
ISSN	1791-7549 ; 0258-851X
ISSN (online)	1791-7549
ISSN	0258-851X
DOI	10.21873/invivo.11765
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Zs.A 2288: Show issues

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Article ; Online: Stratification Using hTERT and Stem Cell Markers Confers a Good Prognosis in Invasive Breast Cancer.

Wazir, Umar / Tayeh, Salim / Orakzai, Mona A W / Martin, Tracey A / Jiang, Wen G / Mokbel, Kefah

Cancer genomics & proteomics

2020 Volume 17, Issue 2, Page(s) 169–174

Abstract: Background/aim: In this study, we aimed to investigate the prognostic role of a previously identified panel of 10 stem cell markers stratified against the catalytic subunit of telomerase (hTERT) in human breast cancer.: Materials and methods: The ... ...

Abstract	Background/aim: In this study, we aimed to investigate the prognostic role of a previously identified panel of 10 stem cell markers stratified against the catalytic subunit of telomerase (hTERT) in human breast cancer. Materials and methods: The mRNA copy numbers of these genes were determined using real time quantitative PCR in 124 breast cancer tissues and adjacent non-cancerous tissues. Relations between mRNA levels and survival were analysed using Kaplan-Meier plots and Cox regression analysis. Results: Five genes (BMI1, NES, POU5F1, ALDH1A2 and CDKN1A) correlated with survival when stratified with hTERT and predicted overall (Wilcoxon: p=0.004; Cox: p=0.006) and disease-free (Wilcoxon: p<0.000; Cox: p=0.000) survival. Conclusion: This panel of genes stratified by hTERT could open new avenues for the development of new prognostic tools, as well as for the identification of new research directions regarding breast oncogenesis.
MeSH term(s)	Aldehyde Dehydrogenase 1/genetics ; Aldehyde Dehydrogenase 1/metabolism ; Biomarkers, Tumor/genetics ; Biomarkers, Tumor/metabolism ; Breast Neoplasms/genetics ; Breast Neoplasms/metabolism ; Breast Neoplasms/pathology ; Case-Control Studies ; Cyclin-Dependent Kinase Inhibitor p21/genetics ; Cyclin-Dependent Kinase Inhibitor p21/metabolism ; Female ; Humans ; Nestin/genetics ; Nestin/metabolism ; Octamer Transcription Factor-3/genetics ; Octamer Transcription Factor-3/metabolism ; Polycomb Repressive Complex 1/genetics ; Polycomb Repressive Complex 1/metabolism ; Prognosis ; RNA, Messenger/genetics ; RNA, Messenger/metabolism ; Retinal Dehydrogenase/genetics ; Retinal Dehydrogenase/metabolism ; Survival Analysis ; Survival Rate ; Telomerase/genetics ; Telomerase/metabolism
Chemical Substances	Aldehyde Dehydrogenase 1 ; BMI1 protein, human ; Biomarkers, Tumor ; CDKN1A protein, human ; Cyclin-Dependent Kinase Inhibitor p21 ; NES protein, human ; Nestin ; Octamer Transcription Factor-3 ; POU5F1 protein, human ; RNA, Messenger ; ALDH1A2 protein, human (EC 1.2.1.36) ; Retinal Dehydrogenase (EC 1.2.1.36) ; Polycomb Repressive Complex 1 (EC 2.3.2.27) ; TERT protein, human (EC 2.7.7.49) ; Telomerase (EC 2.7.7.49)
Language	English
Publishing date	2020-02-18
Publishing country	Greece
Document type	Journal Article
ZDB-ID	2144517-5
ISSN	1790-6245 ; 1109-6535
ISSN (online)	1790-6245
ISSN	1109-6535
DOI	10.21873/cgp.20177
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Article ; Online: Does Transdermal Testosterone Increase the Risk of Developing Breast Cancer? A Systematic Review.

Gera, Ritika / Tayeh, Salim / Chehade, Hiba El-Hage / Mokbel, Kefah

Anticancer research

2018 Volume 38, Issue 12, Page(s) 6615–6620

Abstract: Background/aim: Hypoactive sexual desire disorder (HSDD) is hypothesised to manifest in postmenopausal women at onset of menopause due to decreased oestrogen levels. Transdermal testosterone is a potential treatment option. This systematic review ... ...

Abstract	Background/aim: Hypoactive sexual desire disorder (HSDD) is hypothesised to manifest in postmenopausal women at onset of menopause due to decreased oestrogen levels. Transdermal testosterone is a potential treatment option. This systematic review explores the relationship between the incidence of breast cancer and transdermal testosterone use. Materials and methods: Searches were conducted on the PubMed and Ovid databases. In Ovid, the advanced search function was used: 'transdermal testosterone not male'. In PubMed, the following search terms were used: 'transdermal, testosterone, menopausal, women, breast cancer, women'. Abstracts that fitted our initial criteria were further investigated. Results: A total of 25 publications from PubMed and 192 publications from Ovid were initially assessed. Three randomised control trials were judged to have sufficiently met our inclusion criteria. However, these trials were too heterogeneous for a meta-analysis. A systematic review was deemed the most appropriate analysis of the data available. Conclusion: The publications examined in this systematic review suggest that the use of transdermal testosterone to treat HSDD in postmenopausal women does not increase breast cancer incidence. However, further research in the form of adequately powered randomised controlled trials with breast cancer incidence being the primary end point is required in order to confirm this.
MeSH term(s)	Administration, Cutaneous ; Breast Neoplasms/chemically induced ; Breast Neoplasms/epidemiology ; Female ; Humans ; Menopause/drug effects ; Risk Factors ; Sexual Dysfunctions, Psychological/drug therapy ; Testosterone/administration & dosage ; Testosterone/adverse effects ; Transdermal Patch
Chemical Substances	Testosterone (3XMK78S47O)
Language	English
Publishing date	2018-11-28
Publishing country	Greece
Document type	Journal Article ; Systematic Review
ZDB-ID	604549-2
ISSN	1791-7530 ; 0250-7005
ISSN (online)	1791-7530
ISSN	0250-7005
DOI	10.21873/anticanres.13028
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Article ; Online: The Use of Magnetic Seeds and Radiofrequency Identifier Tags in Breast Surgery for Non-palpable Lesions.

Tayeh, Salim / Gera, Ritika / Perry, Nicholas / Michell, Michael / Malhotra, Anmol / Mokbel, Kefah

Anticancer research

2019 Volume 40, Issue 1, Page(s) 315–321

Abstract: Background: Wire-guided localisation (WGL) remains the most widely used technique to guide surgical excision of non-palpable breast lesions worldwide. However, recent technological advances have led to the advent of less invasive radiation-free ... ...

Abstract	Background: Wire-guided localisation (WGL) remains the most widely used technique to guide surgical excision of non-palpable breast lesions worldwide. However, recent technological advances have led to the advent of less invasive radiation-free localisation methods to overcome the limitations of WGL. Patients and methods: This study prospectively evaluated the role of two radiation-free non-wire localisation methods. Magnetic seeds (n=16) and radiofrequency tags (n=6) were deployed under imaging guidance to guide the surgical excision in 19 consecutive patients. Results: The identification/retrieval and migration rates were 100% and 4.5%, respectively. Twenty-one out of 22 (95.5%) cases had clear surgical margins and no complications were observed. All radiologists and the surgeon rated these methods as being much better than wire localisation. Patient satisfaction data were recorded using a linear visual analogue scale (n=10/19). The mean score was 9.7/10 (range=8-10). Conclusion: Our study provides further evidence that radiation-free wireless breast localisation is an effective alternative to WGL.
MeSH term(s)	Adult ; Aged ; Breast Neoplasms/pathology ; Breast Neoplasms/surgery ; Female ; Humans ; Magnetic Phenomena ; Mastectomy ; Middle Aged ; Radio Frequency Identification Device
Language	English
Publishing date	2019-12-14
Publishing country	Greece
Document type	Journal Article
ZDB-ID	604549-2
ISSN	1791-7530 ; 0250-7005
ISSN (online)	1791-7530
ISSN	0250-7005
DOI	10.21873/anticanres.13955
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Article ; Online: Reflector-guided Localization of Non-palpable Breast Lesions: The First Reported European Evaluation of the SAVI SCOUT® System.

Tayeh, Salim / Muktar, Samantha / Heeney, Jennifer / Michell, Michael J / Perry, Nicholas / Suaris, Tamara / Evans, David / Malhotra, Anmol / Mokbel, Kefah

Anticancer research

2020 Volume 40, Issue 7, Page(s) 3915–3924

Abstract: Background: Wire-guided localization (WGL) has been the mainstay for localizing non-palpable breast lesions before excision. Due to its limitations, various wireless alternatives have been developed. In this prospective study, we evaluate the role of ... ...

Abstract	Background: Wire-guided localization (WGL) has been the mainstay for localizing non-palpable breast lesions before excision. Due to its limitations, various wireless alternatives have been developed. In this prospective study, we evaluate the role of radiation-free wireless localization using the SAVI SCOUT® localization at a European centre. Patients and methods: This technique was evaluated in a prospective cohort of 20 patients. The evaluation focused on clinical and pathological parameters in addition to patient and physician acceptance. Results: SAVI SCOUT reflectors (n=23) were deployed to localize 22 occult breast lesions and one axillary lymph node in 20 patients. The mean deployment duration was 5.6 min, with a mean distance from the lesion of 0.6 mm. The migration rate was 0% and the mean identification and retrieval time was 25.1 min. In patients undergoing therapeutic excision for malignancy (n=17), only one (5.9%) required reoperation for positive surgical margins. Radiologists and surgeons rated the technique as better than WGL and patient satisfaction was high. Conclusion: Our study demonstrates that wireless localization using SAVI SCOUT® is an effective and time-efficient alternative to WGL with excellent physician and patient acceptance.
MeSH term(s)	Adult ; Aged ; Breast Neoplasms/diagnostic imaging ; Breast Neoplasms/surgery ; Diagnostic Imaging/instrumentation ; Diagnostic Imaging/methods ; Female ; Humans ; Infrared Rays ; Mammography/instrumentation ; Mammography/methods ; Middle Aged ; Radar
Keywords	covid19
Language	English
Publishing date	2020-07-03
Publishing country	Greece
Document type	Journal Article
ZDB-ID	604549-2
ISSN	1791-7530 ; 0250-7005
ISSN (online)	1791-7530
ISSN	0250-7005
DOI	10.21873/anticanres.14382
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