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Moreno-Palacios E, Martí C, Frías L, Meléndez M, Loayza A, Roca MJ, Córdoba V, Oliver JM, Hernández A, Sánchez-Méndez JI. Breast-Conserving Surgery Guided with Magnetic Seeds vs. Wires: A Single-Institution Experience. Cancers (Basel) 2024; 16:566. [PMID: 38339317 PMCID: PMC10854709 DOI: 10.3390/cancers16030566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
PURPOSE The aim of this study is to describe our initial experience using magnetic seeds (Magseed®) to guide breast-conserving surgery in non-palpable breast lesions and compare the use of magnetic seed with wires to guide breast-conserving surgery in terms of clinical and pathological characteristics. METHODS We performed a retrospective study including all breast-conserving surgeries for non-palpable breast lesions under 16 mm from June 2018 to May 2021. We compared breast-conserving surgeries guided with magnetic seeds (Magseed®) to those guided with wires, analyzing tumor and patient characteristics, surgical time, and pathological results of the surgical specimens. RESULTS Data from 225 cases were collected, including 149 cases guided by magnetic seeds and 76 cases guided by wires. The breast lesion was localized in every case. Both cohorts were similar regarding clinical and pathological characteristics. We found significant statistical differences (p < 0.02) in terms of the median volume (cm3) of the excised specimen, which was lower (29.3%) in the magnetic seed group compared with the wire group (32.5 [20.5-60.0]/46.0 [20.3-118.7]). We did not find significant differences regarding surgical time (min) or the affected or close margins. CONCLUSION In our experience, the use of magnetic seed (Magseed®) is a feasible option to guide breast-conserving surgery of non-palpable lesions and enabled us to resect less breast tissue.
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Affiliation(s)
- Elisa Moreno-Palacios
- Obstetrics and Gynecology Department, Breast Unit H Universitario La Paz, 28046 Madrid, Spain; (C.M.); (L.F.); (M.M.); (A.L.); (A.H.); (J.I.S.-M.)
| | - Covadonga Martí
- Obstetrics and Gynecology Department, Breast Unit H Universitario La Paz, 28046 Madrid, Spain; (C.M.); (L.F.); (M.M.); (A.L.); (A.H.); (J.I.S.-M.)
| | - Laura Frías
- Obstetrics and Gynecology Department, Breast Unit H Universitario La Paz, 28046 Madrid, Spain; (C.M.); (L.F.); (M.M.); (A.L.); (A.H.); (J.I.S.-M.)
| | - Marcos Meléndez
- Obstetrics and Gynecology Department, Breast Unit H Universitario La Paz, 28046 Madrid, Spain; (C.M.); (L.F.); (M.M.); (A.L.); (A.H.); (J.I.S.-M.)
| | - Adolfo Loayza
- Obstetrics and Gynecology Department, Breast Unit H Universitario La Paz, 28046 Madrid, Spain; (C.M.); (L.F.); (M.M.); (A.L.); (A.H.); (J.I.S.-M.)
| | - María José Roca
- Radiology Department, Breast Unit H Universitario La Paz, 28046 Madrid, Spain; (M.J.R.); (V.C.); (J.M.O.)
| | - Vicenta Córdoba
- Radiology Department, Breast Unit H Universitario La Paz, 28046 Madrid, Spain; (M.J.R.); (V.C.); (J.M.O.)
| | - José María Oliver
- Radiology Department, Breast Unit H Universitario La Paz, 28046 Madrid, Spain; (M.J.R.); (V.C.); (J.M.O.)
| | - Alicia Hernández
- Obstetrics and Gynecology Department, Breast Unit H Universitario La Paz, 28046 Madrid, Spain; (C.M.); (L.F.); (M.M.); (A.L.); (A.H.); (J.I.S.-M.)
| | - José Ignacio Sánchez-Méndez
- Obstetrics and Gynecology Department, Breast Unit H Universitario La Paz, 28046 Madrid, Spain; (C.M.); (L.F.); (M.M.); (A.L.); (A.H.); (J.I.S.-M.)
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Gleich B, Schmale I, Nielsen T, Rahmer J. Miniature magneto-mechanical resonators for wireless tracking and sensing. Science 2023; 380:966-971. [PMID: 37262171 DOI: 10.1126/science.adf5451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 05/03/2023] [Indexed: 06/03/2023]
Abstract
Sensor miniaturization enables applications such as minimally invasive medical procedures or patient monitoring by providing process feedback in situ. Ideally, miniature sensors should be wireless, inexpensive, and allow for remote detection over sufficient distance by an affordable detection system. We analyze the signal strength of wireless sensors theoretically and derive a simple design of high-signal resonant magneto-mechanical sensors featuring volumes below 1 cubic millimeter. As examples, we demonstrate real-time tracking of position and attitude of a flying bee, navigation of a biopsy needle, tracking of a free-flowing marker, and sensing of pressure and temperature, all in unshielded environments. The achieved sensor size, measurement accuracy, and workspace of ~25 centimeters show the potential for a low-cost wireless tracking and sensing platform for medical and nonmedical applications.
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Kabeer KK, Gowda SM, Mohd-Isa Z, Thomas MJR, Gopalan V, Jafferbhoy S, Soumian S, Narayanan S, Kirby R, Marla S. An Audit on Oncological Safety with Magseed Localised Breast Conserving Surgery. Indian J Surg Oncol 2022; 13:616-621. [PMID: 36187538 PMCID: PMC9515253 DOI: 10.1007/s13193-022-01531-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/31/2022] [Indexed: 10/18/2022] Open
Abstract
Wire-localised wide local excision (W-WLE) has been standard of care for impalpable breast lesions. Logistics and risks of wire localisation can be challenging. Magseed-localised wide local excision (M-WLE) is an alternative to W-WLE. We compare safety parameters and length of hospital stay (LOS) in patients undergoing M-WLE to W-WLE. All M-WLEs performed at single institution over an 8-month period were included and compared to historic matched cohort of W-WLEs who would have been suitable for Magseed localisation. Data including patient demographics, successful placements, re-excision rates, tumour size, and length of stay (LOS) was analysed. Two hundred thirty-eight patients were included in the study. Cancers were safely excised in all cases. A significant difference in re-excisions rates favouring M-WLE group was seen (2.9% vs 10.4%). Median waiting time to surgery was significantly shorter in M-WLE group (4 h 15 min vs 7 h 3 min). No significant difference in median LOS between the two groups was seen. M-WLE has been shown to be oncologically safe and non-inferior to W-WLE with significantly lower re-excision rate. Reduced pre-operative waiting time in the M-WLE group will have a positive effect on patient journey. Further research should focus on potential impact on day-bed utilisation and theatre efficiency.
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Affiliation(s)
- Kirti Katherine Kabeer
- Department of Breast Surgery, Kauvery Hospital, D-36, 4th Street, Anna Nagar East, Chennai, 600 102 Tamil Nadu India
| | - S. Manoj Gowda
- Department of Breast Surgery, University Hospitals of North Midlands, Stoke-on-Trent, UK
| | - Zatinahhayu Mohd-Isa
- Department of Breast Radiology, University Hospitals of North Midlands, Stoke-on-Trent, UK
| | | | - Vallipuram Gopalan
- Department of Breast Surgery, University Hospitals of North Midlands, Stoke-on-Trent, UK
| | - Sadaf Jafferbhoy
- Department of Breast Surgery, University Hospitals of North Midlands, Stoke-on-Trent, UK
| | - Soni Soumian
- Department of Breast Surgery, University Hospitals of North Midlands, Stoke-on-Trent, UK
| | - Sankaran Narayanan
- Department of Breast Surgery, University Hospitals of North Midlands, Stoke-on-Trent, UK
- Keele University, Newcastle-under-Lyme, Staffordshire UK
| | - Robert Kirby
- Department of Breast Surgery, University Hospitals of North Midlands, Stoke-on-Trent, UK
| | - Sekhar Marla
- Department of Breast Surgery, University Hospitals of North Midlands, Stoke-on-Trent, UK
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Preoperative localisation of nonpalpable breast lesions using magnetic markers in a tertiary cancer centre. Eur Radiol Exp 2022; 6:28. [PMID: 35790602 PMCID: PMC9256869 DOI: 10.1186/s41747-022-00280-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/19/2022] [Indexed: 12/24/2022] Open
Abstract
Background We retrospectively evaluated safety and performance of magnetic seed localisation of nonpalpable breast lesions. Methods We reviewed records of patients with nonpalpable breast lesions preoperative localised by placing magnetic Magseed® marker between February 2019 and December 2020. During surgery, Sentimag® magnetic probe was used to localise the marker and guide surgery. Safety, lesion identification and excision with tumour with free margins and re-excision rate were assessed. Results A total of 77 Magseed® devices were placed into the breasts of 73 patients, 44 under ultrasound and 33 under stereotactic guidance (4 bilateral). All devices were retrieved as were the target lesions. Magnetic marker placement was successful in all cases without any adverse event. Intraoperative identification and excision of the localised lesion were successful in 77 of 77 of cases (100%). In three cases (all of them calcifications with the seed placed under stereotactic guidance), the seed did not reach the exact target position of the biopsy clip; thus, larger excision was needed, with localisation failure attributed to incorrect clip insertion (n = 1) or to clip dislocation (n = 2). Migration of the marker was negligible in all patients. Complete excision after the initial procedure with at least 1-mm disease-free margins was obtained in 74 out of 77 (96.1%) lesions. The re-excision rate was 3 out of 77 (4%). Conclusions Magnetic marker localisation for nonpalpable breast lesions was safe, reliable, and effective in terms of lesion identification, excision with tumour-free margins and re-excision rate.
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Comparison of Wireless Localization Alternatives with Wire Localization for Nonpalpable Breast Lesions. J Am Coll Surg 2022; 234:1091-1099. [PMID: 35703803 DOI: 10.1097/xcs.0000000000000170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Radiofrequency identification tag localization (TL) and magnetic seed localization (MSL) are alternatives to wire localization (WL) for excision of nonpalpable breast lesions. We sought to compare localization methods with respect to operative time, specimen volume, and re-excision rate. STUDY DESIGN A retrospective cohort analysis was performed on TL, MSL, and WL lumpectomies and excisional biopsies at a single institution. Association between localization method and operative time, specimen volume, and re-excision rate was assessed by multiple logistic regression using odds ratios (ORs) and 95% CIs. RESULTS A total of 506 procedures were included: 147 TL (29.0%), 140 MSL (27.7%), and 219 WL (43.3%). On logistic regression analysis, MSL was associated with longer operative times than WL for excisional biopsies only (OR 4.24, 95% CI 1.92 to 9.34, p < 0.001). Mean excisional biopsy time was 39.1 minutes for MSL and 33.0 minutes for WL. Specimen volume did not vary significantly across surgery types between localization methods. In an analysis of all lumpectomies with an indication of carcinoma, marker choice was not associated with rate of re-excision (TL vs WL OR 0.64, 95% CI 0.26 to 1.60, p = 0.342; MSL vs WL OR 1.22, 95% CI 0.60 to 2.49, p = 0.587; TL vs MSL OR 0.65, 95% CI 0.26 to 1.64, p = 0.359). CONCLUSION TL, MSL, and WL are comparable in performance for excision of nonpalpable breast lesions. Although increased operative time associated with MSL vs WL excisional biopsies is statistically significant, clinical significance warrants additional study. With similar outcomes, physicians may choose the marker most appropriate for the patient and setting.
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Constantinidis F, Sakellariou S, Chang SL, Linder S, MacPherson B, Seth S, Gill N, Seth A. Wireless localisation of breast lesions with MagSeed. A radiological perspective of 300 cases. Br J Radiol 2022; 95:20211241. [PMID: 35201906 PMCID: PMC10993964 DOI: 10.1259/bjr.20211241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/31/2022] [Accepted: 02/03/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The purpose of this article is to review the technical and radiological aspects of MagSeed® localisation, to assess its accuracy based on post-localisation mammograms and excision specimen X-rays and to discuss the radiological experience of our institutions. METHODS Two-year data were collected retrospectively from three NHS boards from the West of Scotland. A total of 309 MagSeeds® were inserted under mammographic or ultrasonographic guidance in 300 women with unifocal, multifocal and/or bilateral breast lesions at the day of surgery or up to 30 days prior to it. Radiological review of post-localisation mammograms and intraoperative specimen X-rays as well as a review of the surgical outcomes were performed to assess the accuracy and efficacy of the method. Our experience relating to the technique's strengths and downsides were also noted. RESULTS The MagSeeds® were inserted on average 7.2 days before surgery. The localisation technique was straight forward for the radiologists. In 99% of the cases, the MagSeed® was successfully deployed and 100% of the successfully localised lesions were excised at surgery. There was no difference in the accuracy of the localisation whether this was mammographically or ultrasonographically guided. On post-localisation mammograms, the MagSeed® was radiologically accurately positioned in 97.3% of the cases. No delayed MagSeed® migration was observed. On the specimen X-rays, the lesion was centrally positioned in 45.1%, eccentric within more than 1 mm from the margin in 35.7% and in 14.8% it was at the specimen's margin. The re-excision rate was 18.3%. CONCLUSION The MagSeed® is an accurate and reliable localisation method in breast conserving surgery with good surgical outcomes. ADVANCES IN KNOWLEDGE To our knowledge, the radiological aspects of MagSeed® localisation have not been widely described in peer-reviewed journals thus far.
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Affiliation(s)
| | | | - Sau Lee Chang
- Department of Imaging NHS Greater Glasgow and
Clyde, Glasgow,
UK
| | - Svetlana Linder
- Department of Imaging NHS Greater Glasgow and
Clyde, Glasgow,
UK
| | | | - Subodh Seth
- Department of Surgery NHS Forth Valley,
Larbert, UK
| | - Nicola Gill
- Department of Imaging NHS Forth Valley,
Larbert, UK
| | - Archana Seth
- Department of Imaging NHS Greater Glasgow and
Clyde, Glasgow,
UK
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Ross FA, Elgammal S, Reid J, Henderson S, Kelly J, Flinn R, Miller G, Sarafilovic H, Tovey SM. Magseed localisation of non-palpable breast lesions: experience from a single centre. Clin Radiol 2022; 77:291-298. [PMID: 35177228 DOI: 10.1016/j.crad.2022.01.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 01/06/2022] [Indexed: 11/03/2022]
Abstract
AIM To prospectively analyse patients undergoing magnetic seed (Magseed) localisation (MSL) to evaluate the outcome, and to retrospectively compare re-excision rates for MSL with previous wire-guided localisation (WGL) to assess the hypothesis that the introduction of MSL may lead to a lower re-excision rate. MATERIALS AND METHODS MSL commenced at University Hospital Crosshouse in December 2017. No other changes were made to radiological or surgical practice during this time. Data were collected prospectively on all patients undergoing MSL between December 2017 and December 2019, in a single breast unit. Data were gathered retrospectively on patients who had undergone localised breast procedures between January 2016 and December 2019 for comparison of re-excision rates. RESULTS Two hundred and fifty-five patients underwent MSL surgery between December 2017 and December 2019. Of those, 98% (n=250) patients underwent successful MSL at the first attempt. The Magseed was identified intraoperatively in 100% patients and surgical excision was performed. The re-excision rate reduced from 18.9% in 2016/2017, to 11.6% in 2018/2019 (p=0.098). CONCLUSION In conclusion, Magseed localisation has proved to be a safe and effective way of localising breast lesions, with the advantage of high accuracy. The reduction in re-excision rates at University Hospital Crosshouse with the introduction of Magseed® localisation is a potential benefit, which requires further study.
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Affiliation(s)
- F A Ross
- Department of Surgery, University Hospital Crosshouse, Kilmarnock Road, Crosshouse, East Ayrshire KA2 0BE, UK.
| | - S Elgammal
- Department of Surgery, University Hospital Crosshouse, Kilmarnock Road, Crosshouse, East Ayrshire KA2 0BE, UK
| | - J Reid
- Department of Surgery, University Hospital Crosshouse, Kilmarnock Road, Crosshouse, East Ayrshire KA2 0BE, UK
| | - S Henderson
- Department of Radiology, University Hospital Crosshouse, Kilmarnock Road, Crosshouse, East Ayrshire KA2 0BE, UK
| | - J Kelly
- Department of Radiology, University Hospital Crosshouse, Kilmarnock Road, Crosshouse, East Ayrshire KA2 0BE, UK
| | - R Flinn
- Department of Surgery, University Hospital Crosshouse, Kilmarnock Road, Crosshouse, East Ayrshire KA2 0BE, UK
| | - G Miller
- Department of Surgery, University Hospital Crosshouse, Kilmarnock Road, Crosshouse, East Ayrshire KA2 0BE, UK
| | - H Sarafilovic
- Department of Surgery, University Hospital Crosshouse, Kilmarnock Road, Crosshouse, East Ayrshire KA2 0BE, UK
| | - S M Tovey
- Department of Surgery, University Hospital Crosshouse, Kilmarnock Road, Crosshouse, East Ayrshire KA2 0BE, UK
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Semillas radiactivas y no radiactivas como método de localización quirúrgica de las lesiones mamarias no palpables. Rev Esp Med Nucl Imagen Mol 2022. [DOI: 10.1016/j.remn.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Cebrecos I, Sánchez-Izquierdo N, Ganau S, Mensión E, Perissinotti A, Úbeda B, Bargalló X, Alonso I, Vidal-Sicartb S. Radioactive and non-radioactive seeds as surgical localization method of non-palpable breast lesions. Rev Esp Med Nucl Imagen Mol 2022; 41:100-107. [DOI: 10.1016/j.remnie.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 11/21/2021] [Indexed: 11/28/2022]
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Magnetic seeds: An alternative to wire localization for non-palpable breast lesions. Clin Breast Cancer 2022; 22:e700-e707. [DOI: 10.1016/j.clbc.2022.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 11/15/2022]
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Davis KM, Raybon CP, Monga N, Waheed U, Michaels A, Henry C, Spalluto LB. Image-guided Localization Techniques for Nonpalpable Breast Lesions: An Opportunity for Multidisciplinary Patient-centered Care. JOURNAL OF BREAST IMAGING 2021; 3:542-555. [PMID: 38424951 PMCID: PMC11256989 DOI: 10.1093/jbi/wbab061] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Indexed: 03/02/2024]
Abstract
Selection of a localization method for nonpalpable breast lesions offers an opportunity for institutions to seek multidisciplinary input to promote value-based, patient-centered care. The diverse range of nonpalpable breast and axillary pathologies identified through increased utilization of screening mammography often necessitates image-guided preoperative localization for accurate lesion identification and excision. Preoperative localization techniques for breast and axillary lesions have evolved to include both wire and nonwire methods, the latter of which include radioactive seeds, radar reflectors, magnetic seeds, and radiofrequency identification tag localizers. There are no statistically significant differences in surgical outcomes when comparing wire and nonwire localization devices. Factors to consider during selection and adoption of image-guided localization systems include physician preference and ease of use, workflow efficiency, and patient satisfaction.
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Affiliation(s)
- Katie M. Davis
- Vanderbilt University Medical Center, Department of Radiology and Radiological Sciences, Nashville, TN, USA
| | - Courtney P. Raybon
- Vanderbilt University Medical Center, Department of Radiology and Radiological Sciences, Nashville, TN, USA
| | - Natasha Monga
- Case Western Reserve University, The MetroHealth System, Department of Radiology, Cleveland, OH, USA
| | - Uzma Waheed
- University of Pittsburgh Medical Center, Department of Radiology, Pittsburgh, PA, USA
| | - Aya Michaels
- Newton Wellesley Hospital, Department of Radiology, Newton, MA, USA
| | - Cameron Henry
- Vanderbilt University Medical Center, Department of Radiology and Radiological Sciences, Nashville, TN, USA
| | - Lucy B. Spalluto
- Vanderbilt University Medical Center, Department of Radiology and Radiological Sciences, Nashville, TN, USA
- Vanderbilt Ingram Cancer Center, Nashville, TN, USA
- Veterans Health Administration—Tennessee Valley Healthcare System Geriatric Research, Education, and Clinical Center (GRECC), Nashville, TN, USA
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Žatecký J, Kubala O, Coufal O, Kepičová M, Faridová A, Rauš K, Lerch M, Peteja M, Brát R. Magnetic Seed (Magseed) Localisation in Breast Cancer Surgery: A Multicentre Clinical Trial. Breast Care (Basel) 2021; 16:383-388. [PMID: 34602944 PMCID: PMC8436608 DOI: 10.1159/000510380] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 07/23/2020] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION The aim of this study was to evaluate the accuracy and reliability of the Magseed magnetic marker in breast cancer surgery. METHODS Thirty-nine patients with 41 implanted Magseeds undergoing surgical treatment in 3 surgical oncology departments were included in the retrospective trial to study pilot use of the Magseed magnetic marker in the Czech Republic for localisation of breast tumours or pathological axillary nodes in breast cancer patients. RESULTS Thirty-four breast cancer and 7 pathological lymph node localisations were performed by Magseed implantation. No placement failures, or perioperative detection failures of Magseeds were observed (0/41, 0.0%), but one case of Magseed migration was present (1/41, 2.4%). All magnetic seeds were successfully retrieved (41/41, 100.0%). Negative margins were achieved in 29 of 34 (85.3%) breast tumour localisations by Magseed. CONCLUSION Magseed is a reliable marker for breast tumour and pathological axillary node localisation in breast cancer patients. Magseed is comparable to conventional localisation methods in terms of oncosurgical radicality and safety.
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Affiliation(s)
- Jan Žatecký
- Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Ostrava, Czechia
- Department of Surgery, Silesian Hospital in Opava, Opava, Czechia
| | - Otakar Kubala
- Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Ostrava, Czechia
- Department of Surgery, University Hospital Ostrava, Ostrava, Czechia
| | - Oldřich Coufal
- Department of Surgical Oncology, Masaryk Memorial Cancer Institute, Brno, Czechia
- Department of Surgical Oncology, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Markéta Kepičová
- Department of Surgery, University Hospital Ostrava, Ostrava, Czechia
| | - Adéla Faridová
- Oncogynecology Centre, The Institute for the Care of Mother and Child, Prague, Czechia
| | - Karel Rauš
- Oncogynecology Centre, The Institute for the Care of Mother and Child, Prague, Czechia
| | - Milan Lerch
- Department of Surgery, Silesian Hospital in Opava, Opava, Czechia
| | - Matúš Peteja
- Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Ostrava, Czechia
- Department of Surgery, Silesian Hospital in Opava, Opava, Czechia
| | - Radim Brát
- Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Ostrava, Czechia
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Garzotto F, Comoretto RI, Michieletto S, Franzoso G, Lo Mele M, Gregori D, Bonavina MG, Bozza F, Caumo F, Saibene T. Preoperative non-palpable breast lesion localization, innovative techniques and clinical outcomes in surgical practice: A systematic review and meta-analysis. Breast 2021; 58:93-105. [PMID: 33991806 PMCID: PMC8481910 DOI: 10.1016/j.breast.2021.04.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/31/2021] [Accepted: 04/19/2021] [Indexed: 12/30/2022] Open
Abstract
Pre-operative localization of non-palpable breast lesions with non-wired non-ionizing (NWNI) techniques may improve clinical outcomes as reoperation rate, cosmetic outcome and contribute to organizational aspects improvement in breast-conserving surgery (BCS). However only limited literature is available and clinical studies involving these forefront devices are often small and non-randomized. Furthermore, there is a lack of consensus on free margins and cosmetic outcomes definitions. The objective of the present meta-analysis was to determine the crude clinical outcomes reported for the NWNI techniques on BCS. A literature search was performed of PubMed, Embase and Scopus databases up to February 2021 in order to select all prospective or retrospective clinical trials on pre-operative breast lesion localization done with NWNI devices. All studies were assessed following the PRISMA recommendations. Continuous outcomes were described in averages corrected for sample size, while binomial outcomes were described using the weighted average proportion. Twenty-seven studies with a total of 2103 procedures were identified. The technique is consolidated, showing for both reflectors' positioning and localization nearly the 100% rate of success. The re-excision and clear margins rates were 14% (95% CI, 11-17%) and 87% (80-92%), respectively. Overall, positive margins rates were 12% (8-17%). In studies that compared NWNI and wire localization techniques, positive margin rate is lower for the first techniques (12%, 6-22% vs 17%, 12-23%) and re-excision rate is slightly higher using the latter (13%, 9-19% vs 16%, 13-18%). Pre-operative NWNI techniques are effective in the localization of non-palpable breast lesions and are promising in obtaining clear (or negative) margins minimizing the need for re-excision and improving the cosmetic outcomes. Randomized trials are needed to confirm these findings.
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Affiliation(s)
- Francesco Garzotto
- Breast Radiology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy.
| | - Rosanna Irene Comoretto
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Unit of Biostatistics, Epidemiology and Public Health, University of Padova, Padova, Italy
| | - Silvia Michieletto
- Breast Surgery Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | | | - Marcello Lo Mele
- Department of Medicine (DIMED), Surgical Pathology Unit, University of Padua, Padua, 35121, Italy
| | - Dario Gregori
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Unit of Biostatistics, Epidemiology and Public Health, University of Padova, Padova, Italy
| | | | - Fernando Bozza
- Breast Surgery Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Francesca Caumo
- Breast Radiology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Tania Saibene
- Breast Surgery Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
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Sreedhar S, Maloney J, Hudson S. Introducing SentiMag in a rural setting: A 5-year experience. ANZ J Surg 2021; 91:2404-2410. [PMID: 34309147 DOI: 10.1111/ans.17093] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 06/27/2021] [Accepted: 07/11/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND The Sentimag device is a probe that contains a sensitive magnetometer which detects either an implantable magnetic marker (MagSeed) or an infectable superparamagnetic ironoxide nanoparticle tracer (MagTrace). MagSeed is used to localise impalpable breast lesions; MagTrace is used to identify sentinel lymph nodes. In Australasia, Sentinel lymph node (SLN) biopsy, using radioactive colloid injection, is a mainstay of prognostication in breast surgery in patients with a clinically negative axilla. In addition, radioactive seeds or hookwires have been used to detect impalpable breast lesions. Gisborne Hospital has been using the SentiMag device since June 2016 to both identify sentinel lymph nodes (Magtrace) and impalpable tumours (Magseed). This study gives perspective over more than 5 years on how this new technology can benefit patients and clinicians in the rural setting. METHODS Patient data had been collected by the operative surgeon prospectively and corroborated with the coding department. Consecutive cases performed by a single surgeon were included in this study. Inclusion criteria were: (1) any patient who needed localisation of an impalpable breast lesion; (2) any patient who needed a sentinel lymph node biopsy; (3) cases were collected from January 2013 with the large majority of cases were collected between January 2015 and Jan 2020. Comparisons were made between patients with different localisation methods. Basic demographics were collected at the time of the surgery and outcomes then recorded. Staging, lymph node status, lymph node detection rates and complications were collected. Mode of tumour and sentinel node location was recorded. Financial data was collected from administrative staff via receipts and invoices of purchases to the hospital. RESULTS Of the 125 patients included in this study: 23 underwent magnetic seed insertion; 15 underwent a hookwire insertion; 45 cases used MagTrace injection; 71 cases used radioactive colloid injection. There was a significantly higher detection rate of two or more sentinel nodes in the SentiMag group. (91% vs. 71.8%, p = 0.01). Neither complication rates, nor cancer detection rates were significantly different. Eighty-four (67.2%) cases did not require tumour location. CONCLUSION SentiMag is safe to use in a rural setting. Using the SentiMag system can simplify care for patients and surgeons and was shown to be cost effective in our hospital.
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Affiliation(s)
| | - Jay Maloney
- General Surgical Department, Gisborne Hospital, Gisborne, New Zealand
| | - Steven Hudson
- General Surgical Department, Gisborne Hospital, Gisborne, New Zealand
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Murphy E, Quinn E, Stokes M, Kell M, Barry M, Flanagan F, Walsh SM. Initial experience of magnetic seed localization for impalpable breast lesion excision: First 100 cases performed in a single Irish tertiary referral centre. Surgeon 2021; 20:e36-e42. [PMID: 33840595 DOI: 10.1016/j.surge.2021.02.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Wire guided localization has been widely utilized as the standard method of pre-operative localization of breast lesions. Magnetic seeds were developed to counter some of the disadvantages associated with wires. This aim of this study was to assess outcomes following the introduction of magnetic seeds at a tertiary specialist breast centre. METHODS A retrospective review of a prospective database of the first 100 patients who underwent magnetic seed (Magseed) guided breast surgery between November 2018 and November 2019. Data was collected from 17 wire guided cases completed during the trial phase for comparison. The primary outcome measures were successful excision of index lesion and retrieval of the magnetic seed. Secondary outcomes analyzed included time ready for theatre, post-operative complications and breast margin re-excision rate. RESULTS Of these 100 cases, 85 patients underwent Magseed guided wide local excision for invasive or in-situ carcinoma and 15 underwent Magseed guided diagnostic excision. The primary lesion was excised, and Magseed was retrieved in all 100 cases. 54% of patients were ready to proceed as the first scheduled theatre case of the day, compared to 0% of wire-guided cases. Amongst therapeutic Magseed guided cases, the re-excision rate for margin clearance was 9.4%. CONCLUSION Magseed guided breast excision is a new technology that has been implemented with relative ease in our unit. We have shown that magnetic seed guided surgery reliably localizes lesions, is associated with low re-excision rates without an increase in patient morbidity or mortality and results in improvements in theatre planning and efficiency.
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Affiliation(s)
- Edward Murphy
- Department of Breast Surgery, Mater Mistericordiae University Hospital, Eccles St, Dublin 7, Ireland
| | - Edel Quinn
- Department of Breast Surgery, Mater Mistericordiae University Hospital, Eccles St, Dublin 7, Ireland
| | - Maurice Stokes
- Department of Breast Surgery, Mater Mistericordiae University Hospital, Eccles St, Dublin 7, Ireland
| | - Malcom Kell
- Department of Breast Surgery, Mater Mistericordiae University Hospital, Eccles St, Dublin 7, Ireland
| | - Mitchel Barry
- Department of Breast Surgery, Mater Mistericordiae University Hospital, Eccles St, Dublin 7, Ireland
| | - Fidelma Flanagan
- Department of Radiology, Mater Mistericordiae University Hospital, Eccles St, Dublin 7, Ireland
| | - Siun M Walsh
- Department of Breast Surgery, Mater Mistericordiae University Hospital, Eccles St, Dublin 7, Ireland.
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Simons JM, Scoggins ME, Kuerer HM, Krishnamurthy S, Yang WT, Sahin AA, Shen Y, Lin H, Bedrosian I, Mittendorf EA, Thompson A, Lane DL, Hunt KK, Caudle AS. Prospective Registry Trial Assessing the Use of Magnetic Seeds to Locate Clipped Nodes After Neoadjuvant Chemotherapy for Breast Cancer Patients. Ann Surg Oncol 2021; 28:4277-4283. [PMID: 33417121 DOI: 10.1245/s10434-020-09542-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/14/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Targeted axillary dissection (TAD) involves locating and removing both clipped nodes and sentinel nodes for assessment of the axillary response to neoadjuvant chemotherapy (NAC) by clinically node-positive breast cancer patients. Initial reports described radioactive seeds used for localization, which makes the technique difficult to implement in some settings. This trial was performed to determine whether magnetic seeds can be used to locate clipped axillary lymph nodes for removal. METHODS This prospective registry trial enrolled patients who had biopsy-proven node-positive disease with a clip placed in the node and treatment with NAC. A magnetic seed was placed under ultrasound guidance in the clipped node after NAC. All the patients underwent TAD. RESULTS Magnetic seeds were placed in 50 patients by 17 breast radiologists. All the patients had successful seed placement at the first attempt (mean time for localization was 6.1 min; range 1-30 min). The final position of the magnetic seed was within the node (n = 44, 88%), in the cortex (n = 3, 6%), less than 3 mm from the node (n = 2, 4%), or by the clip when the node could not be adequately visualized (n = 1, 2%). The magnetic seed was retrieved at surgery from all the patients. In 49 (98%) of the 50 cases, the clip and magnetic seed were retrieved from the same node. Surgeons rated the transcutaneous and intraoperative localization as easy for 43 (86%) of the 50 cases. No device-related adverse events occurred. CONCLUSIONS Localization and selective removal of clipped nodes can be accomplished safely and effectively using magnetic seeds.
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Affiliation(s)
- Janine M Simons
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Department of Surgery, Maastricht University, Maastricht, The Netherlands
| | - Marion E Scoggins
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Henry M Kuerer
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Savitri Krishnamurthy
- Department of Anatomic Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Wei T Yang
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Aysegul A Sahin
- Department of Anatomic Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yu Shen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Heather Lin
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Isabelle Bedrosian
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Elizabeth A Mittendorf
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Division of Breast Surgery, Department of Surgery, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA
| | - Alastair Thompson
- Department of Surgery, Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Deanna L Lane
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kelly K Hunt
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Abigail S Caudle
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Singh P, Scoggins ME, Sahin AA, Hwang RF, Kuerer HM, Caudle AS, Mittendorf EA, Thompson AM, Bedrosian I, Teshome M, DeSnyder SM, Meric-Bernstam F, Hunt KK. Effectiveness and Safety of Magseed-localization for Excision of Breast Lesions: A Prospective, Phase IV Trial. ANNALS OF SURGERY OPEN 2020; 1:e008. [PMID: 34017965 PMCID: PMC8130552 DOI: 10.1097/as9.0000000000000008] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 07/22/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE A prospective, phase IV study was conducted to assess the effectiveness of Magseed to localize breast lesions requiring surgical excision. BACKGROUND Since FDA approval in 2016, Magseed has been increasingly used to localize non-palpable lesions due to advantages over wires or radioactive seeds. This is the first prospective, post marketing trial of Magseed. METHODS From 1/2017-2/2018, 107 women with lesions requiring localization were enrolled at a single institution. Primary endpoint was Magseed retrieval rate. Secondary endpoints were adverse events, accuracy of placement, surgery duration and positive margin rate. Clinicians were surveyed for ease of use using a Likert scale. Descriptive statistics and Fisher's exact test were performed to assess univariable associations with positive margins. RESULTS There were 124 Magseeds placed including one marker in 93 subjects, 2 markers in 11 and 3 markers in 3. The majority of lesions were masses (63%) followed by calcifications (24%). All 124 Magseeds were placed within 10mm of the target lesion and surgically retrieved with median operative time of 15min (range 4-47). No device-related adverse events occurred. Of the 98 malignant lesions, 9 had positive margins and 7 of them underwent a second surgery for additional margins. On univariable analysis, age ≤ 50 (25.0% vs 6.4%, p=0.04), lesion histology (p = 0.03), and pathologic T-stage (p = 0.04) were significantly associated with positive margins. Clinicians rated the Magseed very or fairly easy to use in most cases. CONCLUSIONS The Magseed system for localization of non-palpable lesions was effective and safe; all markers were successfully retrieved with margin-negative resections in 91%. This study supports use of Magseed for localization of breast lesions.
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Affiliation(s)
- Puneet Singh
- From the Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Marion E. Scoggins
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Aysegul A. Sahin
- Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Rosa F. Hwang
- From the Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Henry M. Kuerer
- From the Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Abigail S. Caudle
- From the Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Elizabeth A. Mittendorf
- From the Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Alastair M. Thompson
- From the Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Isabelle Bedrosian
- From the Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Mediget Teshome
- From the Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sarah M. DeSnyder
- From the Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Funda Meric-Bernstam
- From the Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Kelly K. Hunt
- From the Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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Mariscal Martínez A, Vives Roselló I, Salazar Gómez A, Catanese A, Pérez Molina M, Solà Suarez M, Pascual Miguel I, Blay Aulina L, Ríos Gozálvez C, Julián Ibáñez JF, Rodríguez Martínez P, Martínez Román S, Margelí Vila M, Luna Tomás MA. Advantages of preoperative localization and surgical resection of metastatic axillary lymph nodes using magnetic seeds after neoadjuvant chemotherapy in breast cancer. Surg Oncol 2020; 36:28-33. [PMID: 33285433 DOI: 10.1016/j.suronc.2020.11.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 11/02/2020] [Accepted: 11/17/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE To assess the safety and effectiveness of magnetic seeds in preoperative localization and surgical dissection of metastatic axillary lymph nodes (LN+) in breast cancer patients with axillary involvement, after neoadjuvant chemotherapy (NAC). In addition, to assess the impact of targeted axillary dissection (TAD) in reducing the rate of false negatives (FN) in sentinel lymph node biopsy (SLNB). MATERIALS AND METHODS A cross-sectional prospective cohort study was conducted from April 2017 to September 2019, including breast cancer patients with axillary lymph node involvement treated with NAC. Prior to NAC, the LN+ were marked by ultrasound-guided clip insertion. After NAC, a magnetic seed (Magseed®) was inserted in the clip-marked lymph node (MLN). During surgery, the MLN was located and removed with the aid of a magnetic detection probe (Sentimag®) and the sentinel lymph node was removed. Axillary lymph node dissection (ALND) was used to determine the rate of FN for SLNB alone and the combination of SLNB and MLN dissection, called TAD. RESULTS The study included 29 patients (mean age, 55; range, 30-78 years). Selective preoperative localization and surgical dissection were successful for all 30 MLNs (100%). The MLN corresponded to the SLN in 50% of cases. After ALND, there were 21.4% (3/14) FN with SLNB alone and 5.9% (1/17) with TAD. CONCLUSIONS Following NAC, selective surgical removal of MLN by preoperative localization using magnetic seeds is a safe and effective procedure with a success rate of 100%. Adding TAD reduces the rate of FN associated with SLNB alone.
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Affiliation(s)
- Antonio Mariscal Martínez
- Breast Diagnostic Imaging Unit (BDIU) Department of Radiology, Hospital Universitari Germans Trias i Pujol (HUGTiP), Badalona, Barcelona, Spain.
| | | | - Angela Salazar Gómez
- Breast Diagnostic Imaging Unit (BDIU) Department of Radiology, Hospital Universitari Germans Trias i Pujol (HUGTiP), Badalona, Barcelona, Spain
| | - Alessandro Catanese
- Breast Diagnostic Imaging Unit (BDIU) Department of Radiology, Hospital Universitari Germans Trias i Pujol (HUGTiP), Badalona, Barcelona, Spain
| | - Mariola Pérez Molina
- Breast Diagnostic Imaging Unit (BDIU) Department of Radiology, Hospital Universitari Germans Trias i Pujol (HUGTiP), Badalona, Barcelona, Spain
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Retrospective Review of Preoperative Radiofrequency Tag Localization of Breast Lesions in 848 Patients. AJR Am J Roentgenol 2020; 217:605-612. [PMID: 33084384 DOI: 10.2214/ajr.20.24374] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND. Advantages of radiofrequency tags for preoperative breast lesion localization include decoupling of tag placement from surgical schedules and improved patient comfort. OBJECTIVE. The purpose of this study was to evaluate the feasibility of a preoperative localization radiofrequency tag system for breast lesions requiring surgical excision. METHODS. The cohort for this retrospective study included consecutive patients who underwent image-guided needle localization with radiofrequency tags before surgical excision from July 12, 2018, to July 31, 2019. Images and medical records were reviewed to evaluate the pathologic diagnoses serving as indications for tag placement, imaging guidance for tag placement, number of tags placed, and target lesion type. Tag placement technical accuracy rate (defined as deployment of the tag within 1 cm of the edge of the target), success (defined as technical accuracy without complication), and surgical margin and reexcision status were evaluated. RESULTS. A total of 1013 tags were placed under imaging guidance in 848 patients (mean age, 60 years; range, 23-96 years) and 847 subsequently underwent surgical excision. Tags were most commonly placed for invasive carcinoma (537/1013, 53.0%), ductal carcinoma in situ (138/1013, 13.6%), and high-risk lesions (289/1013, 28.5%). A total of 673 (66.4%) tags were deployed under mammographic guidance, whereas 340 (33.6%) were placed under sonographic guidance. Two or more tags were placed in 149 of 848 patients (17.6%). Targeted lesion types primarily included masses (448/1013, 44.2%), biopsy clip markers (331/1013, 32.7%), and calcifications (155/1013, 15.3%). Technical accuracy of placement was achieved in 1004 (99.1%) tags. Of the nine inaccurate tag placements, seven (77.8%) required an additional tag or wire placement. Seven (0.7%) biopsy clip markers were displaced within the breast or removed by the tag device during placement. No complications were reported intraoperatively. Therefore, success was achieved in 997 (98.4%) tags. Tags were successfully retrieved in all 847 patients who underwent surgery. Of the 568 patients with a preoperative diagnosis of carcinoma, 86 (15.1%) had positive or close surgical margins requiring surgical reexcision. CONCLUSION. Preoperative image-guided localization with radiofrequency tags is a safe and feasible technique for breast lesions requiring surgery. CLINICAL IMPACT. Radiofrequency tag localization is an acceptable alternative to needle or wire localization, offering the potential for improved patient workflow and experience.
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20
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Micha AE, Sinnett V, Downey K, Allen S, Bishop B, Hector LR, Patrick EP, Edmonds R, Barry PA, Krupa KDC, Rusby JE. Patient and clinician satisfaction and clinical outcomes of Magseed compared with wire-guided localisation for impalpable breast lesions. Breast Cancer 2020; 28:196-205. [PMID: 32974810 PMCID: PMC7796883 DOI: 10.1007/s12282-020-01149-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 08/17/2020] [Indexed: 01/09/2023]
Abstract
Background Guide-wire localisation remains the most commonly used technique for localisation of impalpable breast lesions in the UK. One alternative is magnetic seed localisation. We aimed to investigate patient and clinician satisfaction in two consecutive cohorts, describe re-excision and positive margin rates, and explore reasons for positive margins and the implications for localisation techniques. Methods A single-institution prospective service evaluation of two cohorts of consecutive cases of wire and then Magseed localisation was carried out. Data were collected on patient and clinician satisfaction, clinico-pathological findings, and causes of involved margins. T tests were used to compare continuous variables and Chi-squared test for satisfaction outcomes. Results 168 consecutive cases used wire-guided localisation (WGL) and 128 subsequent cases used Magseeds. Patients reported less anxiety between localisation and surgery in the Magseed group, and clinicians reported greater ease of use of Magseeds. There were no differences in lesion size, surgical complexity, or re-excision rate between the groups. In a subset of patients receiving standard wide local excision (i.e., excluding mammoplasties), the impact on margin involvement was investigated. There was no significant difference in radiological under-sizing or accuracy of localisation. However, specimen weight and eccentricity of the lesion were statistically significantly lower in the Magseed group. Despite this, re-excision rates were not significantly different (p = 0.4). Conclusions This is the first large study of satisfaction with localisation and showed clinician preference for Magseed and a reduction in patient anxiety. It also demonstrated similar positive margin rates despite smaller specimen weights in the Magseed group. Magnetic seed localisation offers an acceptable clinical alternative to guide wire localisation. The impact on local service provision should also be considered.
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Affiliation(s)
- Aikaterini E Micha
- Royal Marsden NHS Foundation Trust, Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, Surrey, UK
| | - Victoria Sinnett
- Royal Marsden NHS Foundation Trust, Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, Surrey, UK
| | - Kate Downey
- Royal Marsden NHS Foundation Trust, Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, Surrey, UK
- Royal Marsden NHS Foundation Trust, London, UK
| | - Steve Allen
- Royal Marsden NHS Foundation Trust, Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, Surrey, UK
- Royal Marsden NHS Foundation Trust, London, UK
| | - Briony Bishop
- Royal Marsden NHS Foundation Trust, London, UK
- Bedfordshire Hospitals NHS Trust, South Wing, Kempston Rd, Bedford, MK42 9DJ, UK
| | - Lauren R Hector
- Royal Marsden NHS Foundation Trust, Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, Surrey, UK
| | - Elaine P Patrick
- Royal Marsden NHS Foundation Trust, Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, Surrey, UK
| | | | - Peter A Barry
- Royal Marsden NHS Foundation Trust, Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, Surrey, UK
- Institute for Cancer Research, Sutton, UK
| | - Katherine D C Krupa
- Royal Marsden NHS Foundation Trust, Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, Surrey, UK
| | - Jennifer E Rusby
- Royal Marsden NHS Foundation Trust, Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, Surrey, UK.
- Institute for Cancer Research, Sutton, UK.
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Layeequr Rahman R, Puckett Y, Habrawi Z, Crawford S. A decade of intraoperative ultrasound guided breast conservation for margin negative resection - Radioactive, and magnetic, and Infrared Oh My…. Am J Surg 2020; 220:1410-1416. [PMID: 32958157 DOI: 10.1016/j.amjsurg.2020.09.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 06/11/2020] [Accepted: 09/03/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND The oncologic goal of margin-negative breast conservation requires adequate localization of tumor. Intraoperative ultrasound remains most feasible but under-utilized method to localize the tumor and assess margins. METHODS A prospectively maintained breast cancer database over a decade was queried for margin status in breast cancer patients undergoing breast conservation. Techniques of tumor localization, margin re-excision and closest margins were analyzed. Rate of conversion to mastectomy was determined. RESULTS Of the 945 breast cancer patients treated at a university-based Breast Center of Excellence between January 1, 2009 and December 31, 2018, 149(15.8%) had ductal carcinoma in situ; 712(75.3%) had invasive ductal carcinoma, and 63(6.7%) had invasive lobular carcinoma. Clinical stage distribution was: T1 = 372(39.4%); T2 = 257(27.2%); T3 = 87(9.2%). Five hundred and eighty three (61.7%) patients underwent breast conservation. The median (25th -75th centile) closest margin was 6(2.5, 10.0) mm. Thirty five (6.0%) patients underwent margin re-excision, of which 9(25%) were converted to mastectomy. Tumor localization was achieved with ultrasound in 521(89.4%) patients and with wire localization in 62(10.6%) patients. The median (25th-75th centile) closest margin with wire localization was 5.0(2.0, 8.5) mm versus 5.0 (2.0, 8.0) mm with ultrasound guidance [p = 0.6635]. The re-excision rate with wire localization was 14.5% versus 4.9% with ultrasound guidance [p = 0.0073]. The unadjusted Odds Ratio (95% CI) for margin revision in wire localized group compared with ultrasound was 3.2 (7.14, 1.42) [p = 0.0045]; multivariate adjusted OR (95%) was 4(9.09, 1.7) [p = 0.0013]. CONCLUSIONS Ultrasound guidance for localization of breast cancer remains the most effective option for margin negative breast conservation.
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Affiliation(s)
- Rakhshanda Layeequr Rahman
- Texas Tech University Health Sciences Center, Department of Surgery, MS 8312, 3601 Fourth Street Lubbock, Texas, 79430, USA.
| | - Yana Puckett
- Texas Tech University Health Sciences Center, Department of Surgery, MS 8312, 3601 Fourth Street Lubbock, Texas, 79430, USA.
| | - Zaina Habrawi
- Texas Tech University Health Sciences Center, Department of Surgery, MS 8312, 3601 Fourth Street Lubbock, Texas, 79430, USA.
| | - Sybil Crawford
- University of Massachusetts, Medical School Division of Preventive and Behavioral Medicine, Department of Medicine, 55 Lake Avenue North, Shaw Building Room 228, Worcester, Massachusetts, 01655, USA.
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Laws A, Dillon K, Kelly BN, Kantor O, Hughes KS, Gadd MA, Smith BL, Lamb LR, Specht M. Node-Positive Patients Treated with Neoadjuvant Chemotherapy Can Be Spared Axillary Lymph Node Dissection with Wireless Non-Radioactive Localizers. Ann Surg Oncol 2020; 27:4819-4827. [PMID: 32740737 DOI: 10.1245/s10434-020-08902-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 06/30/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND Targeted axillary dissection (TAD) involves sentinel lymph node biopsy (SLNB) and excision of a biopsy-proven node marked by a clip. This study evaluates the feasibility of non-radioactive wireless localizers for targeted excision of clipped axillary lymph nodes. METHODS We identified biopsy-proven, node-positive breast cancer patients treated with neoadjuvant therapy (NAT) and TAD from 2016 to 2020, and included those with a clipped node localized using SAVI SCOUT, Magseed, or RFID Tag. Primary outcome measures were (1) successful localization (ultrasound or mammographic-guided placement < 10 mm from target), and (2) retrieval of the clipped node during TAD, documented by specimen radiography or gross visualization. Secondary outcomes included rates of completion axillary lymph node dissection (cALND) and complications. RESULTS Overall, 57 patients were included; 1 (1.8%) patient had no clip visible at the time of localization, and no radiographic confirmation of clip placement at the time of biopsy, and was therefore excluded. In the remaining 56 patients, localization was successful in 53 (94.6%) patients and the clipped node was retrieved during TAD in 51 (91.1%) patients. Twenty-three of 27 (85.2%) ypN0 patients were spared cALND; 3 (11.1%) patients had cALND for failed clipped node retrieval during TAD, and 1 (3.7%) for false-positive frozen section. In patients with TAD alone, the rates of axillary seroma and infection were 20.0% and 8.6%, respectively. CONCLUSIONS Wireless non-radioactive localizers are feasible for axillary localization after NAT, with high success rates of retrieving clipped nodes. The lack of signal decay is an advantage of these devices, allowing flexibility in timing of placement.
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Affiliation(s)
- Alison Laws
- Department of Surgical Oncology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 7B, Boston, MA, 02114, USA
| | - Kayla Dillon
- Department of Surgical Oncology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 7B, Boston, MA, 02114, USA
| | - Bridget N Kelly
- Department of Surgical Oncology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 7B, Boston, MA, 02114, USA
| | - Olga Kantor
- Department of Surgical Oncology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 7B, Boston, MA, 02114, USA
| | - Kevin S Hughes
- Department of Surgical Oncology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 7B, Boston, MA, 02114, USA
| | - Michele A Gadd
- Department of Surgical Oncology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 7B, Boston, MA, 02114, USA
| | - Barbara L Smith
- Department of Surgical Oncology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 7B, Boston, MA, 02114, USA
| | - Leslie R Lamb
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Michelle Specht
- Department of Surgical Oncology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 7B, Boston, MA, 02114, USA.
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Marín C, Piñero A, Marín P, Galindo P, Guzmán F. Use of a Ferromagnetic Marker for the Intraoperative Detection of Interpectoral Lymph Node Metastasis of Colorectal Cancer. Cir Esp 2020; 98:632-634. [PMID: 32273119 DOI: 10.1016/j.ciresp.2019.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 12/31/2019] [Accepted: 12/31/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Caridad Marín
- Departamento de Cirugía General y Aparato Digestivo, Hospital Virgen de la Arrixaca, El Palmar, Murcia, España.
| | - Antonio Piñero
- Departamento de Cirugía General y Aparato Digestivo, Hospital Virgen de la Arrixaca, El Palmar, Murcia, España
| | - Pedro Marín
- Departamento de Cirugía General y Aparato Digestivo, Hospital Virgen de la Arrixaca, El Palmar, Murcia, España
| | - Pedro Galindo
- Departamento de Cirugía General y Aparato Digestivo, Hospital Virgen de la Arrixaca, El Palmar, Murcia, España
| | - Florentina Guzmán
- Servicio de Radiología, Hospital Virgen de la Arrixaca, El Palmar, Murcia, España
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Bick U, Trimboli RM, Athanasiou A, Balleyguier C, Baltzer PAT, Bernathova M, Borbély K, Brkljacic B, Carbonaro LA, Clauser P, Cassano E, Colin C, Esen G, Evans A, Fallenberg EM, Fuchsjaeger MH, Gilbert FJ, Helbich TH, Heywang-Köbrunner SH, Herranz M, Kinkel K, Kilburn-Toppin F, Kuhl CK, Lesaru M, Lobbes MBI, Mann RM, Martincich L, Panizza P, Pediconi F, Pijnappel RM, Pinker K, Schiaffino S, Sella T, Thomassin-Naggara I, Tardivon A, Ongeval CV, Wallis MG, Zackrisson S, Forrai G, Herrero JC, Sardanelli F. Image-guided breast biopsy and localisation: recommendations for information to women and referring physicians by the European Society of Breast Imaging. Insights Imaging 2020; 11:12. [PMID: 32025985 PMCID: PMC7002629 DOI: 10.1186/s13244-019-0803-x] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 10/10/2019] [Indexed: 12/13/2022] Open
Abstract
We summarise here the information to be provided to women and referring physicians about percutaneous breast biopsy and lesion localisation under imaging guidance. After explaining why a preoperative diagnosis with a percutaneous biopsy is preferred to surgical biopsy, we illustrate the criteria used by radiologists for choosing the most appropriate combination of device type for sampling and imaging technique for guidance. Then, we describe the commonly used devices, from fine-needle sampling to tissue biopsy with larger needles, namely core needle biopsy and vacuum-assisted biopsy, and how mammography, digital breast tomosynthesis, ultrasound, or magnetic resonance imaging work for targeting the lesion for sampling or localisation. The differences among the techniques available for localisation (carbon marking, metallic wire, radiotracer injection, radioactive seed, and magnetic seed localisation) are illustrated. Type and rate of possible complications are described and the issue of concomitant antiplatelet or anticoagulant therapy is also addressed. The importance of pathological-radiological correlation is highlighted: when evaluating the results of any needle sampling, the radiologist must check the concordance between the cytology/pathology report of the sample and the radiological appearance of the biopsied lesion. We recommend that special attention is paid to a proper and tactful approach when communicating to the woman the need for tissue sampling as well as the possibility of cancer diagnosis, repeat tissue sampling, and or even surgery when tissue sampling shows a lesion with uncertain malignant potential (also referred to as "high-risk" or B3 lesions). Finally, seven frequently asked questions are answered.
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Affiliation(s)
- Ulrich Bick
- Clinic of Radiology, Charité Universitätsmedizin Berlin, 10117, Berlin, Germany
| | - Rubina M Trimboli
- PhD Course in Integrative Biomedical Research, Department of Biomedical Science for Health, Università degli Studi di Milano, Via Mangiagalli, 31, 20133, Milan, Italy
| | - Alexandra Athanasiou
- Breast Imaging Department, MITERA Hospital, 6, Erithrou Stavrou Str. 151 23 Marousi, Athens, Greece
| | - Corinne Balleyguier
- Department of Radiology, Gustave-Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - Pascal A T Baltzer
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Wien, Austria
| | - Maria Bernathova
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Wien, Austria
| | | | - Boris Brkljacic
- Department of Diagnostic and Interventional Radiology, University Hospital Dubrava, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Luca A Carbonaro
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Paola Clauser
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Wien, Austria
| | - Enrico Cassano
- Breast Imaging Division, European Institute of Oncology, Milan, Italy
| | - Catherine Colin
- Radiology Unit, Hospices Civils de Lyon, Centre Hospitalo-Universitaire Femme Mère Enfant, 59 Boulevard Pinel, 69 677, Bron Cedex, France
| | - Gul Esen
- School of Medicine, Department of Radiology, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
| | - Andrew Evans
- Dundee Cancer Centre, Clinical Research Centre, Ninewells Hospital and Medical School, Tom McDonald Avenue, Dundee, UK
| | - Eva M Fallenberg
- Diagnostic and Interventional Breast Imaging, Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Michael H Fuchsjaeger
- Division of General Radiology, Department of Radiology, Medical University Graz, Auenbruggerplatz 9, 8036, Graz, Austria
| | - Fiona J Gilbert
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Hills road, Cambridge, CB2 0QQ, UK
| | - Thomas H Helbich
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Wien, Austria
| | | | - Michel Herranz
- CyclotronUnit, GALARIA-SERGAS, Nuclear Medicine Department and Molecular ImagingGroup, Instituto de Investigación Sanitaria (IDIS), Santiago de Compostela, Spain
| | - Karen Kinkel
- Institut de Radiologie, Clinique des Grangettes, Chemin des Grangettes 7, 1224 Chêne-Bougeries, Genève, Switzerland
| | - Fleur Kilburn-Toppin
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Hills road, Cambridge, CB2 0QQ, UK
| | - Christiane K Kuhl
- University Hospital of Aachen, Rheinisch-Westfälische Technische Hochschule, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Mihai Lesaru
- Radiology and Imaging Laboratory, Fundeni Institute, Bucharest, Romania
| | - Marc B I Lobbes
- Department of Radiology, Zuyderland Medical Center, Dr. H. van der Hoffplein 1, PO Box 5500, 6130 MB, Sittard-Geleen, The Netherlands
| | - Ritse M Mann
- Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Laura Martincich
- Unit of Radiodiagnostics ASL AT, Via Conte Verde 125, 14100, Asti, Italy
| | - Pietro Panizza
- Breast Imaging Unit, Scientific Institute (IRCCS) Ospedale San Raffaele, Via Olgettina, 60, 20132, Milan, Italy
| | - Federica Pediconi
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy
| | - Ruud M Pijnappel
- Department of Imaging, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Katja Pinker
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Wien, Austria.,Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, 300 E 66th Street, New York, NY, 10065, USA
| | - Simone Schiaffino
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Tamar Sella
- Department of Diagnostic Imaging, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Isabelle Thomassin-Naggara
- Department of Radiology, Sorbonne Université, APHP, Hôpital Tenon, 4, rue de la Chine, 75020, Paris, France
| | - Anne Tardivon
- Department of Radiology, Institut Curie, Paris, France
| | - Chantal Van Ongeval
- Department of Radiology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Matthew G Wallis
- Cambridge Breast Unit and NIHR Biomedical Research Unit, Box 97, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
| | - Sophia Zackrisson
- Diagnostic Radiology, Department of Translational Medicine, Faculty of Medicine, Lund University, Skåne University Hospital Malmö, SE-205 02, Malmö, Sweden
| | - Gabor Forrai
- Department of Radiology, Duna Medical Center, Budapest, Hungary
| | | | - Francesco Sardanelli
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. .,Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy.
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Abstract
OBJECTIVE. The purpose of this study was to review preoperative CT-guided seed localization in the breast and axilla performed at my institution for lesions not visualized on routine mammography and ultrasound after neoadjuvant chemotherapy. CONCLUSION. Ten lesions (seven in the axilla, two in the breast, and one in the supraclavicular region) were localized with a radioactive seed under CT guidance. All were successfully excised at surgery, suggesting that CT guidance can be used when needle localization is not feasible using mammography or sonography.
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Feasibility of Magnetic Seeds for Preoperative Localization of Axillary Lymph Nodes in Breast Cancer Treatment. AJR Am J Roentgenol 2019; 213:953-957. [DOI: 10.2214/ajr.19.21378] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Kapoor MM, Patel MM, Scoggins ME. The Wire and Beyond: Recent Advances in Breast Imaging Preoperative Needle Localization. Radiographics 2019; 39:1886-1906. [PMID: 31560614 DOI: 10.1148/rg.2019190041] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Many patients with breast cancer are candidates for breast conservation therapy. This group includes individuals with small nonpalpable tumors detected at screening mammography and those with sufficient tumor shrinkage after neoadjuvant chemotherapy. Breast conservation surgery often requires the use of an imaging-guided preoperative localization procedure, during which a device is placed within or adjacent to the target lesion to guide the surgeon intraoperatively. For decades, wire localization has been the standard for preoperative localization in breast imaging. With this method, a wire is placed in the breast percutaneously, with the distal wire segment positioned adjacent to the abnormality and the proximal wire segment remaining outside the breast. Because of the external component of the wire, the patient must be compliant, and care must be taken to not disturb the wire's position before surgery. Scheduling flexibility is also limited because the wire localization must be performed on the same day as the subsequent surgery. More recently, the available options for performing preoperative localization have expanded greatly and now include the use of nonwire devices such as radioactive and magnetic seeds, radar reflectors, and radiofrequency identification tags. Nonwire localization devices can be placed days in advance of the surgery, at the patient's convenience, to avoid wire-related challenges and complications. They are placed percutaneously within or adjacent to the target breast lesion and detected intraoperatively by using a probe outside the breast.©RSNA, 2019.
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Affiliation(s)
- Megha Madhukar Kapoor
- From the Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350, Houston, TX 77030
| | - Miral Mahesh Patel
- From the Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350, Houston, TX 77030
| | - Marion Elizabeth Scoggins
- From the Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350, Houston, TX 77030
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Preoperative localization of breast lesions: Current techniques. Clin Imaging 2019; 56:1-8. [DOI: 10.1016/j.clinimag.2019.01.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 12/12/2018] [Accepted: 01/15/2019] [Indexed: 11/18/2022]
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Evaluation of a Nonradioactive Magnetic Marker Wireless Localization Program. AJR Am J Roentgenol 2018; 211:W202. [DOI: 10.2214/ajr.18.19901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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