Evidence map›Paper›PMID 33640932›Full record

Trial reportThe British journal of surgery2021

Surgical outcomes after radioactive 125I seed versus hookwire localization of non-palpable breast cancer: a multicentre randomized clinical trial.

D B Taylor, A G Bourke, E J Westcott, M L Marinovich, C Y L Chong, R Liang, R L Hughes, E Elder, C M Saunders

Open access · hybridAbstract readComparative StudyMulticenter StudyPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The British journal of surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
1.2field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 27 citations in OpenAlex.

  1. Article
  2. Article
  3. SCOUTCancers · 2025
    Article
  4. Localization Devices and the Surgeon Innovator.Annals of surgical oncology · 2024
    Article
  5. Review
  6. Article
  7. Article
  8. Article
  9. The Safe Use ofCancers · 2023
    Article
  10. Review
  11. Article
  12. Breast surgery: a narrative review.The Medical journal of Australia · 2022
    Review
  13. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 7 institutions in 2 countries.

D B TaylorBreast Clinic, Royal Perth Hospital, Perth, Western Australia, Australia.
A G BourkeDivision of Surgery, Medical School, University of Western Australia, Crawley, Perth, Western Australia, Australia.
E J WestcottDepartment of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, Perth, Western Australia, Australia.
M L MarinovichSchool of Public Health, Curtin University, Bentley, Perth, Western Australia, Australia.
C Y L ChongMonash Health School of Clinical Sciences, Monash University, Clayton, Melbourne, Victoria, Australia.
R LiangDepartment of Surgery, Gold Coast Hospital and Health Service, Robina, Queensland, Australia.
R L HughesRadiology Department, Waikato District Health Board, Hamilton, New Zealand.
E ElderWestmead Breast Cancer Institute, Westmead Hospital, Westmead, Sydney, New South Wales, Australia.
C M SaundersBreast Clinic, Royal Perth Hospital, Perth, Western Australia, Australia.
The University of Western Australia · AUGold Coast Hospital · AUMonash Health · AUSt John of God Subiaco Hospital · AUThe University of Sydney · AUWaikato District Health Board · NZWestmead Hospital · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrevious studies have suggested improved efficiency and patient outcomes with 125I seed compared with hookwire localization (HWL) in breast-conserving surgery, but high-level evidence of superior surgical outcomes is lacking. The aim of this multicentre pragmatic RCT was to compare re-excision and positive margin rates after localization using 125I seed or hookwire in women with non-palpable breast cancer.

methodsBetween September 2013 and March 2018, women with non-palpable breast cancer eligible for breast-conserving surgery were assigned randomly to preoperative localization using 125I seeds or hookwires. Randomization was stratified by lesion type (pure ductal carcinoma in situ (DCIS) or other) and study site. Primary endpoints were rates of re-excision and margin positivity. Secondary endpoints were resection volumes and weights.

resultsA total of 690 women were randomized at eight sites; 659 women remained after withdrawal (125I seed, 327; HWL, 332). Mean age was 60.3 years in the 125I seed group and 60.7 years in the HWL group, with no difference between the groups in preoperative lesion size (mean 13.2 mm). Lesions were pure DCIS in 25.9 per cent. The most common radiological lesion types were masses (46.9 per cent) and calcifications (28.2 per cent). The localization modality was ultrasonography in 65.5 per cent and mammography in 33.7 per cent. The re-excision rate after 125I seed localization was significantly lower than for HWL (13.9 versus 18.9 per cent respectively; P = 0.019). There were no significant differences in positive margin rates, or in specimen weights and volumes.

conclusionRe-excision rates after breast-conserving surgery were significantly lower after 125I seed localization compared with HWL. Registration number: ACTRN12613000655741 (http://www.ANZCTR.org.au/).

Indexed as

Iodine RadioisotopesMargins of ExcisionBreast NeoplasmsCarcinoma, Intraductal, NoninfiltratingFemaleHumansMastectomy, SegmentalMiddle AgedSurgery, Computer-AssistedTreatment OutcomeIodine Radioisotopes

Identifiers

PMID33640932
PMCPMC10364908
OpenAlexW3125827063

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.