Using carbon nanoparticles to localize nonpalpable breast masses in breast conservative surgery: A single-arm pilot study

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Abstract

Introduction
The development of highly sensitive screening methods for early detection of breast cancer (BC) resulted in an epidemic of newly identified nonpalpable BC masses. In the era of breast conservative surgery where minimizing resections and maximizing aesthetics is the goal, exploring new techniques to fulfill these targets is mandatory. Carbon nanoparticles (CNs) display a good profile and may be a significant tool in localizing these lesions.
Aims and objectives
To examine the feasibility of CNs in localizing nonpalpable lesions, to explore its effects on cancer-free resection margins, and to evaluate the aesthetic outcomes of surgery guided by these techniques.
Patients and methods
This is a prospective, single-arm, open-label pilot study of 20 patients (=20) with nonpalpable breast masses undergoing breast conservative surgery with CN localization. All patients had preoperative staging procedures and metastasis workup. Mean age was 50.05 ± 9.8 years. Initial staging revealed that 18 (90%) patients were T1N0M0 and two (10%) patients were T2N1M0, those two patients were downstaged with six cycles of neoadjuvant chemotherapy.
Results
Successful localization occurred in all patients (100%) with no complications or allergic adverse outcomes. Mean diameter of tissues removed was 4.35 ± 1.1 cm. Aesthetic outcomes postoperatively (based on Rose classification) were as follows: 14 (70%) excellent, three (15%) good, two (10%) fair, and one (5%) poor. No postoperative complications (dye persistence, incision infection, significant seroma, or mortality) occurred in any patient.
Conclusions
CN injection for early localization of nonpalpable BC lesions is effective, with a high safety profile and largely acceptable aesthetic outcomes.

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