Use of Radioactive Seed Localization to Guide Removal of a Nonpalpable Endometriotic Lesion: A Case Report

Purpose: To compare the positive margin rates for women with nonpalpable breast tumors whom had wire localization compared to radioactive seed localization in a small community hospital.Introduction: Wire localized (WL) breast biopsies have been performed on patients with nonpalpable breast lesions for many years. Radioactive seed localization (RSL) offers advantages of patient comfort and scheduling convenience.There is an extensive literature from large centers regarding the RSL technique. Little is known whether physicians performing these procedures in smaller community hospitals can achieve comparable negative margin rates as those performed with wire localization.Methods: The thirty-six patients who underwent wire localized breast conserving surgery between September 18, 2013 and December 10, 2014, were compared to the 48 radioactive seed localization patients resected between February 12, 2014 and December 18, 2014. The primary objective was to determine if the introduction of the radioactive seed localization technique significantly changed the positive margin rate.Results: Two of 36 wire localized breast biopsied patients had positive margins, compared to 5 of 48 radioactive seed localization patients, a difference which is not statistically different. The specimen weight was larger for the patients treated with the RSL technique. There was a trend toward a higher positive margin rate with older patients.Conclusion: The positive margin rate was similar between the wire localized and radioactive seed localized patients, and comparable to those in the published literature.

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Resection margins and local recurrences of impalpable breast cancer: Comparison between radioguided occult lesion localization (ROLL) and radioactive seed localization (RSL)

The Breast ◽

10.1016/j.breast.2019.07.004 ◽

2019 ◽

Vol 47 ◽

pp. 93-101

Author(s):

Laura Niinikoski ◽

Katja Hukkinen ◽

Marjut H.K. Leidenius ◽

Päivi Vaara ◽

Aleksandar Voynov ◽

...

Keyword(s):

Breast Cancer ◽

Resection Margins ◽

Local Recurrences ◽

Radioguided Occult Lesion Localization ◽

Occult Lesion ◽

Seed Localization ◽

Radioactive Seed Localization ◽

Radioactive Seed ◽

Lesion Localization

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A Single-Institute Experience With Radioactive Seed Localization of Breast Lesions—A Retrospective Study

Canadian Association of Radiologists Journal ◽

10.1177/0846537119885682 ◽

2020 ◽

Vol 71 (1) ◽

pp. 58-62

Author(s):

Klaudia Jumaa ◽

Badria Al Johani ◽

Muriel Brackstone ◽

Anat Kornecki

Keyword(s):

Radiology Department ◽

Resection Margins ◽

Breast Lesions ◽

Seed Migration ◽

Seed Loss ◽

Seed Localization ◽

Radioactive Seed Localization ◽

Malignant Lesions ◽

Radioactive Seed ◽

Mean Time

Objectives: To assess the benefits associated with radioactive seed localization (RSL) in comparison to conventional wire localization (WL) for nonpalpable breast lesions. Methods: Radioactive seed localization was initiated at our institution in July 2013. Retrospective review of all WL performed between June 2012 and July 2013 (2013) and all RSL performed during June 2015 and July 2016 (2016). Patients who received neoadjuvant therapy or did not undergo their planned surgeries and WL performed in 2016 were excluded. The following data were collected: final pathology, resection margins for malignant lesions, time to surgery, seed migration, and number of localized lumpectomies performed by each surgeon. Results: A total of 292 WL procedures (288 women) in 2013 and 194 RSL procedures (186 women) in 2016 were eligible for the study. All WLs were inserted the day of surgery. Mean time from RSL insertion to surgery was 4.0 ± 2.8 days (range: 1-17 days). There was no difference in specimen size for malignant lesions (6.8 ± 2.8 cm for WL and 6.9 ± 2.9 cm for RSL; P = .5). Specimen radiographs were obtained in 233 (80%) of 292 WL compared to 194 (100%) of 194 RSL ( P < .001). For malignant lesions, positive margins were present in 34 (17.2%) of 198 with WL compared to 15 (10.3%) of 146 with RSL ( P < .001). Close margins (≤1 mm) were present in 31 (15.6%) of 198 with WL compared to 1 (0.6%) of 146 with RSL ( P < .001). The seed fell out of the specimen during surgery in 6 (3.1%) of 194. No seed loss was recorded. The surgeons (n = 4) who transitioned to RSL increased the number of surgeries per month from a mean of 4.4 ± 2.6 in 2013 to 6.9 ± 3.5 in 2016, equivalent to a 41% increase ( P = .003). Conclusions: The use of RSL, as compared to conventional WL, resulted in a reduction in the number of pathologically involved surgical margins and was associated with an increased number of surgeries. Furthermore, RSL can be performed up to 14 days prior to surgery, which may improve scheduling flexibility in the radiology department.

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