Image-guided Localisation of Nonpalpable Breast Lesions: a Comparative Analysis of Magnetic Seeds and Hookwires in an Asian Population

Abstract

Objectives: To compare the procedural outcomes of magnetic seed localisation and hookwire localisation (HWL) of nonpalpable breast lesions in an Asian population. Methods: We performed a retrospective review of 91 nonrandomised female patients who underwent breast surgery after image-guided magnetic seed localisation or HWL from July 2019 to June 2021. Rates of placement success (defined as marker-lesion distance <10 mm), lesion detection, marker retrieval, and complications, were compared. Results: A total of 48 patients received magnetic seeds, and 43 patients received hookwires for preoperative localisation; a total of 100 lesions (50/100, 50.0% Magseed vs. 50/100, 50.0% hookwire) were marked and excised. Magnetic seeds were placed 0 to 126 days before surgery (median=14); of the 50 lesions marked, 22 were removed on the same day and 28 on a later day. Placement success was identical between the two groups, 98.0% magnetic seeds versus 98.0% hookwire. All lesions were detected at the first operation and successfully excised; all markers were removed intact without complications. Conclusion: Magnetic seed localisation demonstrated comparable procedural success and safety to conventional HWL in Asian patients with thinner and denser breasts. It could be an effective alternative to HWL, with the additional advantage of decoupling localisation and surgery dates.