Radioactive Seed Localization or Wire-guided Localization of Nonpalpable Invasive and In Situ Breast Cancer

Langhans, Linnea; Tvedskov, Tove Filtenborg; Klausen, Thomas Levin; Jensen, Maj-Britt; Talman, Maj-Lis Møller; Vejborg, Ilse; Benian, Cemil; Roslind, Anne; Hermansen, J; Oturai, Peter; Bentzon, N; Kroman, Niels

doi:10.1097/sla.0000000000002101

Cited by 75 publications

(80 citation statements)

References 21 publications

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“…RNFL thickness decreased in chronic heavy smokers, and the thinning is related to the amount of smoking rather than duration; and it could be due to direct neurotoxic effect on the optic nerve and reduced blood flow due to the vasoconstrictive effect of nicotine [23]. …”

Section: Discussionmentioning

confidence: 99%

Effect of Active and Passive Smoking on Retinal Nerve Fibre Layer and Ganglion Cell Complex

El-Shazly

Farweez

Elewa

et al. 2017

Journal of Ophthalmology

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Aim. To evaluate the possible structural and functional changes in the retinal nerve fibre layer (RNFL) and the ganglion cell complex (GCC) of chronic smokers and compare them with those of passive healthy smokers using spectral domain optical coherence tomography (SD-OCT) and pattern electroretinogram (PERG). Materials and Methods. We include 80 active chronic smokers and 80 age- and sex-matched healthy passive smokers. After a full ophthalmological examination, SD-OCT and PERG were tested for all participants. Urinary levels of cotinine and creatinine with subsequent calculation of the cotinine creatinine ratio (CCR). Results. Inferior and superior quadrants of RNFL were thinner in group I, but nasal and temporal quadrants did not show significant difference between the groups. There were no significant differences of GCC values between the two groups. There was no significant difference of PERG-P50 amplitude and latency; however, PERG-N95 showed significant difference between the two groups. Multiple regression analyses demonstrated that the number of cigarettes/day, urinary cotinine, and PERG-N95 amplitude are the most important determinants for both superior and inferior RNFL thicknesses. Conclusion. RNFL thickness decreases in chronic, healthy, heavy cigarette smokers, and this thinning is related to the number of cigarettes/day, urinary cotinine, and PERG-N95 latency and amplitude.

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Section: Discussionmentioning

confidence: 99%

Effect of Active and Passive Smoking on Retinal Nerve Fibre Layer and Ganglion Cell Complex

El-Shazly

Farweez

Elewa

et al. 2017

Journal of Ophthalmology

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“…Alternative methods such as Iodine ( 125 I) radioactive seed localization (RSL) and Radio Occult Lesion Localisation (ROLL) are equally reliable and are used in a number of centres in order to overcome some of the disadvantages of wire localisation [3]. Iodine seed localisation can be performed prior to the day of surgery.…”

Section: Introductionmentioning

confidence: 99%

Is the future magnetic? Magseed localisation for non palpable breast cancer. A multi-centre non randomised control study

Zacharioudakis

Down

Bholah

et al. 2019

European Journal of Surgical Oncology

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Introduction: Magseed is an alternative method of localising non-palpable breast lesions that has addressed many of the limitations of wire guided localisation (WGL). It consists of a paramagnetic seed that can be visualised on mammography and ultrasound. Intraoperative localisation of the seed is achieved with the use of the Sentimag probe. The aim of this study was to prospectively compare localisation in patients undergoing wide local excision (WLE) for non-palpable lesions between Magseed and WGL. Methods: We prospectively collected data on all patients undergoing image-guided WLE between October 2017 and September 2018 in two academic breast units with a planned accrual of 100 consecutive patients undergoing Magseed localisation. Data was also collected on a cohort of 100 consecutive patients undergoing WGL in the same time period. Results: Demographic and disease characteristics were well balanced between the two groups. 4/104 patients were converted preoperatively from Magseed to WGL (2 misplaced Magseeds; 2 undetected Magseeds). Intraoperative identification and excision of the localised lesion was successful in all patients as confirmed with specimen radiography. Overall no significant differences were observed in the proportion of patients requiring re-excision between the two groups (Magseed 16% vs. WGL 14% p ¼ 0.692). Specimens size by weight and volume was similar for both groups (Magseed 39.6 g vs. WGL 44.5 g p ¼ 0.206 and 90.1 cm 3 for Magseed vs. 95.6 cm 3 for WGL p ¼ 0.579). Conclusions: In our series Magseed localisation proved to be as reliable and effective as WGL in terms of lesion identification, excision with tumour free margins and specimen weight.

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“…Within a complex health care delivery system, radiologists must understand how their innovation efforts are affected by other stakeholders. For example, despite the overwhelming evidence that preoperative breast lesion localization with radioactive seeds is preferred by patients and offers superior outcomes over wire localization (34), physician preference for wire localization has hindered adoption (35). Proactive inclusion of breast surgeons in a project to replace wire localization with radioactive seed localization is crucial to inform implementation and ensure smooth adoption.…”

Section: Culture: Creating a Fertile Environment For Innovationmentioning

confidence: 99%

Creating Value through Incremental Innovation: Managing Culture, Structure, and Process

Rubin

Abramson

2018

Radiology

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While the looming threat of large-scale disruptive innovation consumes disproportionate attention, incremental innovation remains an important tool for preserving and growing radiology practices within a dynamic marketplace. Incremental innovation, defined as the process of making improvements or additions to an organization while maintaining the organization's core product or service model, is accessible to practices of all sizes and must not be overlooked if practices are to maintain their competitive advantage. This article explores cultural, structural, and process enablers for incremental innovation. Successful innovation cultures foster the ability to import and exploit external knowledge (adaptive capacity), encourage creative thought from all levels of the organization, display sensitivity toward the competency-destroying potential of certain changes, cultivate a positive perceptual bias toward organizational threats, and build tolerance for risk and uncertainty when prototyping new ideas. Structural elements promoting incremental innovation include dedicated resources for innovation planning, flexible and organic team structures, strong centralized governance models, robust communication systems, and organizational incentives encouraging exploration of new concepts. Processes important to innovation include periodic environmental scanning, strategic and scenario planning, use of an objectively gated system for testing and filtering new ideas, and use of an approach to implementation that emphasizes empowerment of project managers, removal of barriers, and proactive communication around change.

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Radioactive Seed Localization or Wire-guided Localization of Nonpalpable Invasive and In Situ Breast Cancer

Abstract: RSL offers a major logistic advantage, as localization can be done several days before surgery without any increase in positive resection margins compared with WGL.

Cited by 75 publications

References 21 publications

Effect of Active and Passive Smoking on Retinal Nerve Fibre Layer and Ganglion Cell Complex

Effect of Active and Passive Smoking on Retinal Nerve Fibre Layer and Ganglion Cell Complex

Is the future magnetic? Magseed localisation for non palpable breast cancer. A multi-centre non randomised control study

Creating Value through Incremental Innovation: Managing Culture, Structure, and Process

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