P157. The use of Magnetic Seeds for Lesion Localisation in Breast Surgery – The North Wales Experience

Sirianni, Chiara; Cochrane, R.; Gash, A; Gate, Tim; Gandakasuma, Benedict; Khattak, Ilyas; Powell, Meena; Abou-Samra, Walid; Pennick, Mandana

doi:10.1016/j.ejso.2019.01.177

Cited by 1 publication

(1 citation statement)

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“…We then proceeded to screen the full texts, when available, for the 21 abstracts which initially met the criteria for analysing Magseed localisation efficacy (9,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). Five studies were excluded from the localisation/identification rate calculation because these data was not provided or were unclear (12,15,21) or because the total number of Magseeds used was unclear (13,22). Hence, 16 studies were used to calculate the rates of successful localisation and placement in the pooled analysis (9,11,14,(16)(17)(18)(19)(20)(23)(24)(25)(26)(27)(28)(29)(30).…”

Section: Resultsmentioning

confidence: 99%

Evolving Role of Magseed in Wireless Localization of Breast Lesions: Systematic Review and Pooled Analysis of 1,559 Procedures

Gera

Tayeh

Al-Reefy³

et al. 2020

Anticancer Res

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Background/Aim: Wire-guided localisation (WGL) remains the most widely used technique for the localisation of non-palpable breast lesions; however, recent technological advances have resulted in non-wire, non-radioactive alternatives, such as magnetic seeds (Magseeds). The aim of this pooled analysis was to determine whether Magseeds are an effective tool for localising non-palpable breast lesions. Materials and Methods: Various databases were searched for publications which reported data on the localisation and placement rates of Magseed. Data on re-excision rates under use of Magseed and WGL were also collected. Results: Sixteen studies, spanning the insertion of 1,559 Magseeds, were analysed. The pooled analysis showed a successful placement rate of 94.42% and a successful localisation rate of 99.86%. Four studies were analysed in a separate pooled analysis and showed no statistically significant difference between reexcision rates using Magseeds and WGL. Conclusion: The use of Magseeds is an effective, non-inferior alternative to WGL that overcomes many of the limitations of the latter. The pre-operative localisation of non-palpable breast cancer traditionally employs wire-guided localisation (WGL) (1). However, several limitations are associated with WGL. The localisation wire can cause manifold complications, such as diathermy burns, pericardial injury and wire dislocation/ transection (2, 3). Furthermore, wire migration and surgical difficulties in accurately assessing the position of the wire tip intraoperatively can pose significant difficulty for the operating surgeon (4). WGL is performed on the day of surgery, and interdepartmental coordination with radiology for localisation in addition to everyday scheduling difficulties may lead to a prolonged surgical waiting time. An underreported limitation of the flexible wire used in WGL is that it increases the risk of needle-stick injury for the surgeon and the pathologist. Furthermore, it protrudes from the breast and is uncomfortable for the patient. The prospect of an additional procedure on the day of major breast surgery can also be very stressful for patients in whom anxiety level is already high (2). Widespread use of screening methods has led to an increased incidence of non-palpable breast cancer. It is therefore imperative that localisation methods with high patient, radiologist and surgical satisfaction rates are developed. Radioactive seed localisation (RSL) is a feasible alternative to WGL. RSL can occur up to 5 days prior to the surgery and the seeds can be accurately detected with a hand-held gamma probe (5). Furthermore, recent evidence suggests that RSL would be more cost-effective than WGL (6) and would improve the oncological outcomes of imageguided surgery (7). However, handling of radioactive material requires special licensing and is associated with strict regulatory requirements. Hence, the optimal solution would be a non-wire non-radioactive localisation method which contains no energy source. This has led to the emergence of Savi Sco...

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