Abstract
Background
Nonpalpable breast lesions require precise preoperative localization to facilitate negative margins with breast-conserving therapy. The traditional use of wires has several challenges including patient discomfort, wire migration, and coordination of schedules between radiology and the operating room. Radioactive seed localization overcomes some of these challenges, but radiation safety requirements have limited adoption of this technology. The authors examined their institutional experience with Magseed as an alternative technology for localization and compared outcomes with those of wire and radioactive seed localization.
Methods
An institutional review board (IRB)-approved retrospective study was performed to evaluate patients who underwent excisional biopsy or segmental mastectomy after wire-guided localization (WGL), radioactive seed localization (RSL), or Magseed localization (ML). The clinical and pathologic factors of the three groups were assessed with a negative margin rate as the primary outcome measure.
Results
Of the 1835 patients in the study, 825 underwent WGL, 449 underwent RSL, and 561 underwent ML. For the patients with either multiple lesions or a large lesion that required bracketing, multiple localization devices were placed in 31% of the WGL patients, 28% of the RSL patients, and 23% of the ML patients (p = 0.006). Negative margins were achieved in 91% of the WGL patients, 89% of the RSL patients, and 89% of the ML patients (p = 0.4).
Conclusion
Localization of non-palpable breast lesions using Magseed is a safe and effective alternative to WGL and RSL that overcomes radiation safety limitations and increases radiology and surgery scheduling efficiency.
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Change history
17 March 2022
A Correction to this paper has been published: https://doi.org/10.1245/s10434-022-11652-8
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Acknowledgments
This study was supported by MD Anderson Cancer Center Core Grant P30 CA016672. C. K. Luo is supported by the Cancer Prevention and Research Institute of Texas (CPRIT RP210028).
Disclosure
Kelly K. Hunt, MD, serves on the medical advisory board for Armada Health and receives research funding to her institution from Cairn Surgical, Eli Lilly & Co., and Lumicell. The remaining authors have no conflicts of interest.
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Liang, D.H., Black, D., Yi, M. et al. Clinical Outcomes Using Magnetic Seeds as a Non-wire, Non-radioactive Alternative for Localization of Non-palpable Breast Lesions. Ann Surg Oncol 29, 3822–3828 (2022). https://doi.org/10.1245/s10434-022-11443-1
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DOI: https://doi.org/10.1245/s10434-022-11443-1