A MODIFIED INTRAOPERATIVE LOCALIZATION TECHNIQUE FOR EARLY BREAST CANCER IN RESOURCE-CONSTRAINED SETTINGS durbansurgeon@gmail.com

 

A MODIFIED INTRAOPERATIVE LOCALIZATION TECHNIQUE FOR EARLY BREAST CANCER IN RESOURCE-CONSTRAINED SETTINGS

1

South Africa

Poster with Discussion

The increasing detection of non-palpable breast lesions through population-based mammographic screening poses logistical and financial challenges, particularly in resource-limited environments. Standard localization techniques—such as wire-guided or clip-marker localization—necessitate additional imaging support, specialized personnel, and expensive equipment, which may not be readily accessible in such settings. These limitations can lead to more invasive surgical approaches and higher rates of re-excision.

This study presents a modified intraoperative localization technique utilizing surgeon-performed ultrasound and intraoperative dye tattooing, designed to improve surgical accuracy while minimizing costs and patient discomfort. Preoperative planning is conducted during the outpatient consultation. Intraoperatively, ultrasound is used to localize the lesion under general anaesthesia, reducing patient anxiety and procedural discomforts and risks of displacement. A diluted dye, originally intended for sentinel node identification, is repurposed to mark the lesion site, allowing direct visualization and excision during surgery, ensuring no further costs are incurred during the procedure.

This approach demonstrated improved localization accuracy, reduced re-excision rates compared to published benchmarks, and enhanced cosmetic outcomes with the surgeon having the ability to accurately plan the surgical access pathway. The technique is reproducible, requires no significant additional training, and can be integrated into existing surgical workflows without reliance on external imaging services.

In conclusion, this cost-effective and patient-centred strategy enhances the surgical management of early breast cancer in resource-constrained settings, promoting equitable care while maintaining high standards of oncological safety and aesthetic outcomes.