The introduction of radioactive seed localisation improves the oncological outcome of image guided breast conservation surgery

Pieri, Andrew; Milligan, Robert A.; Critchley, Adam; O’Donoghue, J.M.; Sibal, Nidhi; Peace, Richard; Petrides, George; Howitt, Rachel; Nicholson, S; Cain, Henry

doi:10.1016/j.breast.2017.09.004

Cited by 14 publications

(7 citation statements)

References 23 publications

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“…This important factor should be considered and accounted for in order to make accurate, equitable and comparable measurement of outcomes between the two cohorts. This was demonstrated by Pieri et al in a series of 233 consecutive cases localised by RSL where an improvement in re-excision rate was observed following the initial learning curve [17].…”

Section: Discussionmentioning

confidence: 77%

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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Section: Discussionmentioning

confidence: 77%

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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“…Wires and magnetic seeds are both highly effective at localizing lesions, and the majority of complications are related to adjuncts to surgery rather than the localization technique. Several single-unit, smaller studies have demonstrated a reduction in re-excision rate after adopting the new technology, particularly for radioactive seeds 31 . However, these studies have selection bias and are generally single site.…”

Section: Discussionmentioning

confidence: 99%

Wire- and magnetic-seed-guided localization of impalpable breast lesions: iBRA-NET localisation study

Dave

Barrett

Morgan

et al. 2022

British Journal of Surgery

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Background Wire localization is historically the most common method for guiding excision of non-palpable breast lesions, but there are limitations to the technique. Newer technologies such as magnetic seeds may allow some of these challenges to be overcome. The aim was to compare safety and effectiveness of wire and magnetic seed localization techniques. Methods Women undergoing standard wire or magnetic seed localization for non-palpable lesions between August 2018 and August 2020 were recruited prospectively to this IDEAL stage 2a/2b platform cohort study. The primary outcome was effectiveness defined as accurate localization and removal of the index lesion. Secondary endpoints included safety, specimen weight and reoperation rate for positive margins. Results Data were accrued from 2300 patients in 35 units; 2116 having unifocal, unilateral breast lesion localization. Identification of the index lesion in magnetic-seed-guided (946 patients) and wire-guided excisions (1170 patients) was 99.8 versus 99.1 per cent (P = 0.048). There was no difference in overall complication rate. For a subset of patients having a single lumpectomy only for lesions less than 50 mm (1746 patients), there was no difference in median closest margin (2 mm versus 2 mm, P = 0.342), re-excision rate (12 versus 13 per cent, P = 0.574) and specimen weight in relation to lesion size (0.15 g/mm2 versus 0.138 g/mm2, P = 0.453). Conclusion Magnetic seed localization demonstrated similar safety and effectiveness to those of wire localization. This study has established a robust platform for the comparative evaluation of new localization devices.

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“…Ultimately, the localisation approach applied is likely to consider multiple clinical resource and other local factors, however utilizing shared learning practice and prior awareness of potential complications may improve surgical outcomes in both groups. An analysis comparing consecutive re-excision rates for wire-guided and radio-active seed breast lesion excisions [27], demonstrated better margin clearances following sharing of expertise and clinical experience. By sharing learning outcomes associated with localisation techniques in this analysis, it is hypothesised will shorten the learning curve and potential for adverse events, although further empirical evidence is necessary to validate this.…”

Section: Discussionmentioning

confidence: 99%

Results of shared learning of a new magnetic seed localisation device – A UK iBRA-NET breast cancer localisation study

Morgan

Bromley

Dave

et al. 2022

European Journal of Surgical Oncology

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The introduction of radioactive seed localisation improves the oncological outcome of image guided breast conservation surgery

Cited by 14 publications

References 23 publications

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

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

Wire- and magnetic-seed-guided localization of impalpable breast lesions: iBRA-NET localisation study

Results of shared learning of a new magnetic seed localisation device – A UK iBRA-NET breast cancer localisation study

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