Global research trends and thematic evolution of imaging-guided localization in breast cancer surgery: a bibliometric analysis.

BACKGROUND: Imaging-guided localization has become an essential component of contemporary breast cancer surgery, particularly with the increasing detection of nonpalpable lesions and the widespread use of neoadjuvant chemotherapy. Over the past two decades, diverse imaging modalities and localization techniques have been developed; however, the global research landscape, thematic evolution, and collaborative structure of this field have not been comprehensively evaluated. Therefore, this study aimed to perform a comprehensive bibliometric analysis of imaging-guided localization in breast cancer surgery. METHODS: On November 15, 2025, the Web of Science Core Collection (WoSCC) was searched to retrieve relevant publications. Following eligibility screening, articles concerning imaging-guided localization and surgical management of breast cancer published between 2000 and 2025 were incorporated. Bibliometric indicators, collaboration networks, citation patterns, and keyword co-occurrence were analyzed using VOSviewer (version 1.6.20) and the Bibliometrix package (version 5.1.1) in R (version 4.3.3). RESULTS: A total of 366 eligible publications were included in the analysis. The annual number of publications increased steadily after 2011, indicating growing research interest; however, the average citation rate per article showed a declining trend in recent years. Country-level analysis revealed a highly centralized collaboration network, with the United States occupying a dominant position in terms of publication output, citation impact, and international connectivity. Keyword co-occurrence analysis demonstrated a clear thematic shift from traditional wire-guided localization and basic imaging techniques toward advanced imaging-guided, precision-oriented surgical approaches, particularly in the context of neoadjuvant chemotherapy. Highly cited studies were predominantly clinical investigations demonstrating the impact of imaging guidance on surgical precision and margin control. CONCLUSIONS: This bibliometric analysis delineates the evolving research landscape of imaging-guided localization in breast cancer surgery, highlighting a transition from feasibility-focused techniques to precision-driven, clinically integrated strategies. While technological innovation has accelerated, the uneven distribution of citation impact suggests a gap between emerging localization methods and evidence consolidation. These findings underscore the need for rigorous comparative studies and international collaboration to support the translation of imaging-guided innovations into standardized clinical practice.