Objectives 

To assess the effectiveness and outcomes of scout-guided excision for impalpable breast lesions, with particular emphasis on its accuracy, efficiency, and overall procedural success. 

 

Methods 

Data was collected between February 2023 and October 2024 at our trust. A total of 67 female patients underwent scout-guided excision, with 5 patients receiving two scouts each, resulting in a total of 72 scouts used majority 97% (70) in the breast, 3% (2) in the axillary lesion. Of these procedures, 76.38% (55) were therapeutic intent to cure and 23.6% (17) were diagnostic, including 13.8% (10) scouts placed in patients undergoing neoadjuvant therapy.  The effectiveness of scout placement was evaluated on histological findings and feedback from operator excising the lesion. 

Results 

Of the excised lesions, 70.83% (51) were malignant, 2.7% (2) were benign, 2.7% (2) were ductal carcinoma in situ (DCIS), and 23.61% (17) were classified as B3 lesions on initial biopsy. All scouts were successfully retrieved without any complication. No device malfunction or failure recorded. Post-operative specimen X-rays were conducted for 72.22% (52) patients as recommended during the training period, Re-excision was required on 15.27% (11) patients due to close/involved margins. Size discrepancies between histological and radiological imaging were observed in 63% (7) of re-excision cases. One patient developed a post-operative hematoma, which was managed conservatively, and no other complications were reported. 

Conclusion 

Scout-guided excision of impalpable breast lesions demonstrated high reliability and efficiency, with consistent scout retrieval and no device failure. The procedure facilitated accurate lesion localization with minimal impact on surgical scheduling. Size discrepancies and margin involvement highlights opportunities for enhancing preoperative planning and improving imaging accuracy.