An Overview of Experience with Preoperative Skin Marking and Clip Insertion in Non-palpable Breast Cancer Lesions in a Tertiary Care Cancer Center and Its Impact on Breast Conservation Surgery

Abstract

Newer adjuncts in breast conservation surgery are striving for more precise excision of these cancerous lesions. This study evaluates two such techniques, preoperative ultrasound-guided lesion clipping and skin marking, and their effects on the surgical outcomes of early breast cancer lesions undergoing breast conservation surgery. This retrospective study includes 56 consecutive patients with non-palpable (upfront or post-neoadjuvant chemotherapy) biopsy-proven early breast cancers (T1, T2, T3 lesions). These patients underwent breast conservation surgery using ultrasound-guided percutaneous clipping and skin marking techniques at Manipal Comprehensive Cancer Center, between January 2019 and May 2021. Post excision, their total specimen volume and tumor volume were studied. Of the total of 56 patients, based on institutional protocol, 33 were clipped before neoadjuvant chemotherapy, and 23 patients underwent skin marking. Mean specimen volume was 99.25 ± 60 cm3, and mean tumor volume was 7.38 ± 13.6 cm3. Forty-seven patients (84%) were managed with a simple local type I oncoplastic procedure. In nine patients (16%), local perforator-based flap reconstruction was done. These techniques help to achieve precise excision of these tumors, requiring a lower volume of resection to achieve negative margins, with better cosmetic outcomes.