Titanium clip placement to allow accurate tumour bed localisation following breast conserving surgery – Audit on behalf of the IMPORT Trial Management Group

摘要: Abstract Introduction Accurate tumour bed (TB) localisation is a key requirement for the UK IMPORT (Intensity Modulated Partial Organ Radiotherapy) trial. We audited value of titanium clips TB following breast conserving surgery (BCS) in radiotherapy (RT) planning. Patients and methods At surgery, paired were positioned around as follows: 1. Medial, lateral, superior inferior: half-way between skin fascia; 2. Posterior: at pectoral 3. Anterior: close to suture line. Thirty consecutive patients with inserted time RT Audit standards set (i) 5/6 pairs identified on planning computed tomography (CT) scan – 100%; (ii) possible clip migration: 50%. Inter- intra-observer variability clinician outlining was studied subset 12 randomly selected see if this impacted positioning field borders. Results Five or six all 30 cases. The could be successfully using CT seroma alone only 8/30 (27%) patients. Clips essential other 22/30 (73%) There no evidence migration. led modified borders 18/30 (60%) these had highly visible seromas, so addition 13/30 (43%) Both inter- reasonable did not impact Conclusion Titanium provide an accurate reliable method BCS. anticipate that audit results will lead being adopted best practice by Association Breast Surgeons (ABS) BASO (British Surgical Oncology).