Magnetic Marker Wireless Localisation versus Radioguided Localisation of Nonpalpable Breast Lesions

Introduction Precise preoperative localisation is essential for nonpalpable breast lesions undergoing lumpectomy. Hookwire localisation has been gradually replaced by radioisotope-guided occult lesion localisation (ROLL). We aimed to evaluate the use of magnetic metal markers (Magseed) as a nonradio...

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Published in:Hong Kong journal of radiology : HKJR = Xianggang fang she ke yi xue za zhi 2021-12, Vol.24 (4), p.247-256
Main Authors: Tsui, HL, Fung, EPY, Kwok, KM, Wong, LKM, Lo, LW, Mak, WS
Format: Article
Language:English
Subjects:
Breast cancer
Case reports
FDA approval
Localization
Magnetic fields
Mammography
Medical diagnosis
Nuclear medicine
Pathology
Patients
Radioisotopes
Scintigraphy
Statistical analysis
Surgery
Surgical outcomes
Ultrasonic imaging
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Summary:Introduction Precise preoperative localisation is essential for nonpalpable breast lesions undergoing lumpectomy. Hookwire localisation has been gradually replaced by radioisotope-guided occult lesion localisation (ROLL). We aimed to evaluate the use of magnetic metal markers (Magseed) as a nonradioactive and wireless alternative. Methods We compared cases of Magseed localisation performed between September 2018 and April 2020 with the same number of ROLL procedures with identical pathology in the same period. Results In total, 24 Magseed and 24 ROLL procedures were included. There were no significant differences between the case groups in terms of target characteristics, operation time, specimen size, pathological diagnosis, margin clearance, or reoperation rate. Localisation duration was significantly shorter in ROLL procedures (8.7 min) compared with Magseed localisation (12.9 min, p < 0.0001). No complications were reported. Same-day surgery was performed in all ROLL and 17 Magseed lesions. The localisation-operation interval for the other seven Magseed lesions were 4 to 14 days. Significantly lower intraoperative re-excision rates (p = 0.006) were observed in the Magseed group (8.3%) compared with the ROLL group (45.8%). Technical success of the ROLL group was 100%. Twenty-two (91.7%) Magseed localisations achieved technical success with 11/11 (100%) using ultrasound and 11/13 (84.6%) using stereotactic guidance. Magseed displacement was up to 4.8 mm in the localisation-operation interval. Conclusion Magseed is a safe and effective localisation technique for nonpalpable breast lesions, which allows decoupling of radiological and surgical schedules.
ISSN:2223-6619
2307-4620
DOI:10.12809/hkjr2117267