Localization of Image-Detected Breast Abnormalities: Radioactive Seed Localization—An Alternative to Wire Localization

Radioactive Seed Localization for Conservative Surgery of Nonpalpable Breast Cancer: Recommendations for Technology Implantation Program

“…The committee assumes responsibility for evaluating the necessary processes and presenting the schedule for program implementation, supervising the implementation process, and writing the institution-specific standard operating procedure protocol. They are also in charge of making sure that pathology, radiology, and surgery staff who plan to handle radioactive seeds are identified and receive the appropriate instruction [ 23 24 ].…”

“…Although Iodine-125 seed is a sealed source for therapeutic use in brachytherapy, its medical use for intraoperative localization is classified as a nuclear medicine procedure. As this is a radioactive material sealed source, the institution should contact the responsible regulatory agency to acquire the appropriate federal and state licensing documentation for each department that will handle the seed and consult the specific regulations [ 18 20 21 22 23 25 ]. If they are imported into the country, additional steps might be necessary.…”

“…The professional team involved in an RSL program is multidisciplinary, as it must include the personnel involved in all seed-handling stages, from request to final disposal. Some specialties are: breast surgeon, radiologist, pathologist, medical physicist, and radiology technologist, plus professionals from related areas such as nurses, pathology assistants, surgical staff, and administrative staff [ 19 20 22 23 ].…”

“…Each professional must have knowledge and/or training on the procedure development at all stages, be aware of the radiation effects, avoiding personnel contamination and their environment. Radiology technologists can be trained at all stages to follow procedures in the three departments, assisting with imaging and handling of radiation detectors [ 22 23 ].…”

“…The materials include radiation warning labels that read “caution: radioactive material”, container and vial labels that identify radioactive materials, containers with appropriate protection of lead or equivalent for seed transport, reverse action tweezers, short-term seed storage in radiology, and long-term seed storage in nuclear medicine. In addition to a storage area for the Iodine-125 decay and deterioration with security system [ 23 26 ]. It will take up to 2 years for the seed to reach discard radiation level [ 27 ].…”