Update on Preoperative Breast Localization

Hayes, Mary K.

doi:10.1016/j.rcl.2016.12.012

Cited by 138 publications

(149 citation statements)

References 23 publications

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“…A significant limitation impeding the use of both RFID tags and Magseeds as localisation techniques is that both can result in signal void artefacts (2 and 4 cm, respectively) during follow-up MRI scans (37); depending on the MRI sequence, the Magseed can create a bloom artefact which measures up to 4 cm. This may hamper the detection of residual disease after neoadjuvant systemic therapy if MRI is required for monitoring response to treatment.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

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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“…Key disadvantages of WGL include the presence of a foreign object in the specimen for pathological assessment, possible wire transection, wire migration before or during surgery, patient distress and discomfort and pneumothorax. Another significant disadvantage of WGL is that the guide-wire does not provide a clear 3D perspective on the tumor [11,12].…”

Section: Discussionmentioning

confidence: 99%

“…It can be performed prior to the day of surgery and the surgeon can accurately localize the device in theater using a handheld gamma probe, similarly as in ROLL procedure. Both RSL and ROLL are equally reliable to wire localization [12], but they suffer from high regulatory barriers and administrative burdens due to their radioactive manipulation.…”

Section: Discussionmentioning

confidence: 99%

“…For several years, the standard technique for intraoperative tumor localization of clinically occult tumors has been wire-associated localization. Here, a hook wire is placed into the tumor under ultrasound, x-ray mammography or MRI guidance [11,12]. However, wire-based localization techniques are associated with disadvantages such as logistical challenges and migration issues.…”

mentioning

confidence: 99%

“…However, wire-based localization techniques are associated with disadvantages such as logistical challenges and migration issues. Radioactive technologies such as radio-guided occult lesion localization (ROLL) and radioactive seed localization (RSL) are used in some hospitals to overcome many of the disadvantages of wire localization, but they are connected with regulatory barriers and administrative burdens due to their radioactive manipulation [11,12].…”

mentioning

confidence: 99%

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Simultaneous Use of Magnetic Method in Localization of Impalpable Breast Cancer and Sentinel Lymph Nodes Detection: Initial Experience

Pohlodek

Foltin

Mečiarová

et al. 2018

Nanomedicine (Lond.)

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In this study we used a new technology for localization of non-palpable breast tumors using a small steel marker in conjunction of sentinel nodes (SLNs) detection through injection of SPIO nanoparticles; both detected through a magnetic probe. Materials & methods: Ten patients with biopsy-proven nonpalpable invasive breast carcinoma or premalignant lesions eligible for SLNs biopsy were enrolled in this study. Results: All tumors were removed with safe surgical margins. The mean nodal detection rate was 3.4 nodes per patient. No interferences in magnetic probe measurements due to the presence of both markers in the same breast were observed. Conclusion: Simultaneous use of the magnetic method in localization of impalpable breast tumors and SNs detection makes breast surgery convenient.

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Exploiting the advantages of a wireless seed localization system that differentiates between the seeds: Breast cancer resection following neoadjuvant chemotherapy

et al. 2022

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Background Most wireless localization methods utilize only one means of detection for the surgeon, sufficient to localize a single small breast lesion for excision. Complex cases requiring bracketing of a larger lesion or localization of two or more close lesions can superimpose the signal from separate “seeds” with such methods. The lack of discernment between the localization “seeds” can disorient the surgeon, risking a missed lesion on excision and longer operative times. with the use of neoadjuvant chemotherapy prior to breast surgery, the necessity of localizing both a breast lesion and an axillary lymph node previously biopsied is becoming frequent. Case A 44 year‐old woman underwent neoadjuvant chmotherapy for a breast cancer the did not express estrogen receptor, progesterone receptor, or HER2 receptor. In establishing the extent of disease, a suspicious ipsilateral lymph node was biopsied and found to contain metastatic disease. She had an excellent response to the chemotherapy, with decreased size of the primary tumor and the previously biopsied lymph node. The patient desired breast conservation. The primary tumor and associated calcifications were bracketed using two different Smartclips™, with a third localizing the lymph node biopsied. Conclusion This report illustrates how the use of three SmartClips™, within the EnVisioTM system, allowed for separate tracking of each “seed” throughout a complex surgery in a patient following neoadjuvant chemotherapy. This resulted in successful resection of both the tumor and the tagged lymph node.

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Update on Preoperative Breast Localization

Cited by 138 publications

References 23 publications

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

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

Simultaneous Use of Magnetic Method in Localization of Impalpable Breast Cancer and Sentinel Lymph Nodes Detection: Initial Experience

Exploiting the advantages of a wireless seed localization system that differentiates between the seeds: Breast cancer resection following neoadjuvant chemotherapy

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