Radiofrequency as a method of localizing impalpable breast lesions.

BACKGROUND: The incidence of early stage breast cancer has risen as a result of increased detection of non-palpable tumors through the implementation of screening programs and greater public awareness. Performing breast-conserving surgery can be challenging due to the need for accurate localization of non-palpable breast lesions, particularly given the logistical difficulties associated with wire localization. After implementing a new technique for localizing non-palpable breast lesions (LOCalizerTM Radiofrequency identification TAG-Hologic®), a radiofrequency identification tag localization device manufactured by Hologic, Inc. in Marlborough, MA, was launched in 2017, our objective was to investigate its impact on surgical outcomes, whether there was an increase in re-excision rates for positive margins and whether the attainment of clear margins was dependent on the exact positioning of the RFID device. METHOD: A single-center single-arm interventional study, data were gathered both in a forward-looking manner for 1 year (prospectively) and by looking back at past records for 1 year (retrospectively) for a total period of two years. Individuals who were diagnosed with non-palpable breast lesions, as confirmed by histological analysis, or invasive breast cancer and who were scheduled to undergo breast-conserving surgery were eligible for inclusion in the study. The RFID (Radiofrequency Identification) method was used to localize the lesions prior to surgery. Either with a mammogram or ultrasound scan position of the Tag was recorded, including the distance of the lesion from the center of the lesion and the lesion depth from the skin in millimeters. The rate of re-excision was documented and examined in relation to the parameters mentioned above. RESULTS: Two hundred and twenty RFID Tags were inserted in two hundred and seventeen (three patient had bilateral tags insertion), patients aged between 30 and 85 had a localizer Tag inserted between Oct 2020 and Oct 2022. Three patients had non-palpable breast lesions in both breasts. Fourteen were inserted under stereotactic guidance and two hundred and six under ultrasound guidance. Ten patients subsequently had wire insertion also due to Tag position. Of 210 procedures, RFIF Tags within the lesion was seen in hundred and sixty patients (76.19 %). An additional 50 procedures were performed using the RFID Tag system, which were not directly related to the lesion but were deemed appropriate to proceed with. Out of a total of 220 procedures, positive margins were observed in 38 cases (17.27 %). Among these cases, eleven (28.94 %) involved the use of the RFID Tag system, not within the lesion but adjacent to it (within 15 mm surrounding the lesion). CONCLUSION: RFID is a good alternative to wire localization of non-palpable breast lesions. Re-excision rates are higher in patients with Tag outside the lesion compared to those with Tag within the lesion.

Awareness, expectation and satisfaction towards ward pharmacy services among patients in medical wards: a multi-centre study in Perak, Malaysia.

BACKGROUND: Patient's awareness and satisfaction towards ward pharmacy services may influence perception towards effectiveness and safety of drugs, affecting medication adherence and clinical outcome. Nevertheless, studies on local ward pharmacy services were lacking. This study evaluated awareness, expectation and satisfaction of ward pharmacy services among patients in medical wards and determined their association with demographic characteristics. METHODS: This was a cross-sectional study using self-administered questionnaire conducted in medical wards of fourteen Perak state public hospitals from September to October 2020. In-patients aged ≥18 years old were included. The validated questionnaire had four domains. The student's t-test, one-way analysis of variance (ANOVA) and multiple linear regression were was employed to evaluate the association between patients' demographic characteristics with their awareness, expectation and satisfaction towards ward pharmacy services. RESULTS: 467 patients agreed to participate (response rate = 83.8%) but only 441 were analysed. The mean age of the patients was 54.9 years. Majority was male (56.2%), Malay (77.3%), with secondary education (62.9%), rural resident (57.1%) and reported good medication adherence (61.6%). The mean awareness score was 49.6 out of 60. Patients were least aware about drug-drug interaction (3.85 ± 1.15) and proper storage of medications (3.98 ± 1.06). Elderly patients (ß = - 2.82, P < 0.001) obtained lower awareness score. Patients with tertiary education (ß = 3.87, P = 0.001), rural residents (ß = 3.65, P < 0.001) and with good medication adherence (ß = 2.55, P = 0.002) had higher awareness score. The mean expectation score was 44.0 out of 50. The patients had higher expectation to encounter a polite ward pharmacist (4.51 ± 0.56). Patients with tertiary education (ß = 1.86, P = 0.024), rural residents (ß = 1.79, P = 0.001) and with good medication adherence (ß = 1.48, P = 0.006) demonstrated higher expectation. The mean satisfaction score was 43.6 out of 50. The patients had high satisfaction in language used (4.45 ± 0.57) and level of knowledge demonstrated (4.41 ± 0.62) by the ward pharmacists. Patients with tertiary education (ß = 2.16, P = 0.009), rural residents (ß = 1.82, P = 0.001) and with good medication adherence (ß = 1.44, P = 0.009) demonstrated higher satisfaction, while elderly patients (ß = - 1.17, P = 0.031) had lower satisfaction towards ward pharmacy services. CONCLUSION: There was a high level of awareness, expectation and satisfaction towards ward pharmacy services in public hospitals of Perak, Malaysia.