Evaluation of Hologic LOCalizer™ RFID Tags for Preoperative Localization of Breast Lesions: A Single-Center Experience

Background: The increasing detection of non-palpable breast lesions necessitates accurate preoperative localization to ensure complete excision while preserving healthy tissue and optimizing cosmetic outcomes. Traditional wire-guided localization (WL) has been the gold standard; however, it has several drawbacks, including patient discomfort and scheduling challenges. This study evaluates the accuracy and feasibility of radiofrequency identification (RFID) tag localization using the Hologic LOCalizer™ system as an alternative technique. Methods: This retrospective study included 258 consecutive patients who underwent image-guided RFID tag localization from March 2021 to February 2023 from a single-center London breast unit. The primary outcome measured was the accuracy of RFID tag placement, defined as within 10 mm of the target lesion on post-clip mammograms. Secondary outcomes included type and size of lesions, re-excision rates, review of post-operative specimen radiographs, and patient demographics. Results: A total of 297 RFID tags were placed, with 95.6% accurately positioned within the target range. The median target size was 29 mm, with the most common abnormalities being mass lesions (64%). Among the 13 inaccurately placed RFID tags (4.4%), all were identified preoperatively, with two requiring additional wire placements. RFID tags were successfully identified in 92% of specimen radiographs, and 8% of patients required re-excision due to positive or close margins. Notably, patients with multiple RFID tags showed a higher incidence of re-excision. Conclusions: The LOCalizer™ RFID system demonstrated a high accuracy rate for preoperative localization of breast lesions, presenting a viable alternative to WL. This technique improves surgical scheduling flexibility and enhances patient comfort. Comparative studies with other wire-free localization technologies, such as magnetic seeds and radar reflectors, are needed to determine the optimal approach for clinical practice.