Experience with Seed Localization for Nonpalpable Breast Lesions in a Public Health Care System
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Seed localization uses a radioactive source to identify nonpalpable breast lesions for excision; it is an emerging alternative to wire localization (WL). Previous single health system studies report decreased rates of re-excision and improved patient convenience with this technique. This study is the first to implement this procedure in a public health care delivery system composed of a primarily minority and low-income population.
Materials and Methods
A multidisciplinary team was formed to create a protocol for breast seed localization (BSL) and monitor the results. After 50 seed localizations were successfully completed, a retrospective matched-pair analysis with patients who had undergone WL during the same period was performed.
Overall experience with the BSL protocol is reviewed, along with the occurrence of a seed loss. Processes necessary to reactivate the BSL protocol and prevent future losses are delineated. BSL is associated with decreased rates of re-excision and can be successfully implemented in a public health care system.
BSL is an attractive alternative to WL in a high-volume, county-based population. It allows increased efficiency in the operating room and has a low rate of complications. Cautionary measures must be taken to ensure proper seed chain of custody to prevent seed loss.
- Siemssen, OJ, Blichert-Toft, M, Pedersen, ML, Olesen, KP, Jensen, LB, Jacobsen, GK (1981) Mammography directed wire marking of nonpalpable breast lesions. A consecutive biopsy study of 100 patients. Acta Chir Scand 147: pp. 525-527
- Jensen, SR, Luttenegger, TJ (1979) Wire localization of nonpalpable breast lesions. Radiology. 132: pp. 484-485
- Rissanen, TJ, Makarainen, HP, Kiviniemi, HO, Suramo, II (1994) Ultrasonographically guided wire localization of nonpalpable breast lesions. J Ultrasound Med. 13: pp. 183-188
- Seifi, A, Axelrod, H, Nascimento, T, Salam, Z, Karimi, S, Avestimehr, S (2009) Migration of guidewire after surgical breast biopsy: an unusual case report. Cardiovasc Intervent Radiol. 32: pp. 1087-1090 CrossRef
- Azoury, F, Sayad, P, Rizk, A (2009) Thoracoscopic management of a pericardial migration of a breast biopsy localization wire. Ann Thorac Surg. 87: pp. 1937-1939 CrossRef
- Gray, RJ, Pockaj, BA, Karstaedt, PJ, Roarke, MC (2004) Radioactive seed localization of nonpalpable breast lesions is better than wire localization. Am J Surg. 188: pp. 377-380 CrossRef
- Gray, RJ, Salud, C, Nguyen, K, Dauway, E, Friedland, J, Berman, C (2001) Randomized prospective evaluation of a novel technique for biopsy or lumpectomy of nonpalpable breast lesions: radioactive seed versus wire localization. Ann Surg Oncol. 8: pp. 711-715 CrossRef
- Hughes, JH, Mason, MC, Gray, RJ, McLaughlin, SA, Degnim, AC, Fulmer, JT (2008) A multi-site validation trial of radioactive seed localization as an alternative to wire localization. Breast J. 14: pp. 153-157 CrossRef
- Cox, CE, Furman, B, Stowell, N, Ebert, M, Clark, J, Dupont, E (2003) Radioactive seed localization breast biopsy and lumpectomy: can specimen radiographs be eliminated?. Ann Surg Oncol. 10: pp. 1039-1047 CrossRef
- Jakub, JW, Gray, RJ, Degnim, AC, Boughey, JC, Gardner, M, Cox, CE (2009) Current status of radioactive seed for localization of non palpable breast lesions. Am J Surg. 199: pp. 522-528 CrossRef
- Rissanen, TJ, Makarainen, HP, Mattila, SI, Karttunen, AI, Kiviniemi, HO, Kallioinen, MJ (1993) Wire localized biopsy of breast lesions: a review of 425 cases found in screening or clinical mammography. Clin Radiol. 47: pp. 14-22 CrossRef
- Experience with Seed Localization for Nonpalpable Breast Lesions in a Public Health Care System
Annals of Surgical Oncology
Volume 17, Issue 12 , pp 3241-3246
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- 1. Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- 2. Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- 3. Radiation Safety, University of Texas Southwestern Medical Center, Dallas, TX, USA
- 4. Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA