Cost-effectiveness of ultrasound-guided surgical clips placement for breast cancer localization prior to neoadjuvant chemotherapy

Abstract

Objective: To evaluate the outcome and the cost value of surgical clips use as guidance for breast cancer localization in patients prepared for neoadjuvant chemotherapy (NAC). Methods: A prospective study of 43 patients confirmed histopathologically to have breast cancer and prepared to receive pre-operative NAC. Surgical clips were inserted via US guidance. The patients were followed up by mammography and US before surgery to evaluate the treatment response meanwhile, assessment of clips location, migration and complications. The overall cost of clips was also calculated. Results: Only 32 patients completed the study; the mean time interval was 32 weeks ± 2 weeks between the clip insertion date and the surgery. The number of the inserted clips was 34 surgical clips. Only two cases showed positive migration yet with no evidence of other complications occurred in our study patients. The average cost of the surgical clips was 145 ± 20 Egyptian pounds (average 8–9 US$). Conclusion: Surgical clips can be used safely to replace the usual commercial markers in the localization of breast cancer before NAC. They showed effective results with no complications, don't interfere with the patients' imaging and of the significant low cost compared to the commercial ones. Keywords: Surgical clips, Ultrasound-guided, Breast cancer, Neoadjuvant chemotherapy