Radioactive Seed Localization Versus Wire-Guided Localization for Nonpalpable Breast Cancer: A Cost and Operating Room Efficiency Analysis

Zhang, Yimeng; Seely, Jean M.; Cordeiro, Erin; Hefler, Joshua; Thavorn, Kednapa; Mahajan, Mukta; Domina, Sue; Aro, Jon; Ibrahim, Andrea Marie; Arnaout, Angel; Gravel, Denis; Nessim, Carolyn

doi:10.1245/s10434-017-6084-z

Cited by 59 publications

(40 citation statements)

References 10 publications

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“…ii In 2016, Dryden et al retrospectively analyzed 565 women with similar results showing no difference in positive margin, re‐excision, and mastectomy rates in the wire compared with radioactive seed localization group . Zhang et al showed decreased costs, increased number of radiology appointments, and more rapid transport to the operating room for radioactive seed localization when compared to wire localization . Additionally, they show a low overall hematoma (overall 1.4%, P = 1.00) and wound infection (overall 3.5%, P = .45) rate, which was not statistically significant in the RSL and WL group.…”

Section: Discussionmentioning

confidence: 99%

Comparison of wire localization, radioactive seed, and Savi scout ^® radar for management of surgical breast disease

et al. 2020

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Background Radioactive seed localization (RSL) and the Savi scout® radar (SSR) are newer alternatives to wire‐guided localization (WL) for nonpalpable breast lesions. Objective To compare three types of localization devices used in breast conserving surgery. Methods A total of 293 patients had a partial mastectomy (n = 194) or breast biopsy (n = 99) with preoperative image‐guided localization of a single nonpalpable lesion between July 2017 to July 2018. Lesions were localized by WL, RSL, or SSR. Although all operations performed were outpatient, due to workflow differences at our institution, operations performed in the hospital operating rooms were defined as “hospital setting.” Operations performed at an outpatient surgery facility without the capacity to admit patients were defined as “ambulatory.” Delay in operating room start times and total perioperative times in both the hospital and ambulatory setting, localization time, explant of localization device, positive margins, volume of tissue excised, and 30‐day complications were evaluated. Results A total of 126 patients (43%) had WL; 59 patients (20%) had RSL; and 108 patients (37%) had SSR localization. SSR localization took longer to perform with an average time of 19 minutes, compared with 15 minutes for WL and 14 minutes for RSL (P = .020). In 93.52% of cases, the first specimen contained both the clip and localization device, which was similar among groups (P = .073). There was no difference in retained biopsy clip among the groups (average 3.4%, P = .173). For operations performed in the hospital, the time from patient arrival to the preoperative area and incision was significantly longer in the WL group with a median of 233 minutes (range 56‐486), 130 minutes (range 64‐294) in RSL, and 108 minutes (range 59‐240) for SSR (P < .001). There was no difference in operative time among the groups with a median of 51 minutes (range 17‐122) (P = .108). There was, however, significantly longer perioperative time of 469 minutes (range 210‐926) in the WL group compared with 399 minutes (range 240‐871) for RSL and 381 minutes (range 232‐711) for SSR (P ≤ .001). For the ambulatory setting, although there was no difference in operating time among the groups (median 50 minutes, range 18‐127, P = .715), only the RSL showed a decreased perioperative time compared to WL (WL 356 vs RSL 275, P < .001; SSR 279, p = NS). A total of 131 patients (44.7%) had same day localizations. Among operations with delayed start times, there was a longer average delay of 85 minutes (range 1‐304) for WL group compared with 69 minutes (range 13‐219) in RSL and 53 minutes (range 0‐228) in SSR (P < .001). There was no difference among the three groups in positive margin rate, volume of tissue excised, and 30‐day complications. Conclusion Nonwire localization devices are associated with reduced overall perioperative time compared to wire localization, with few complications.

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Section: Discussionmentioning

confidence: 99%

Comparison of wire localization, radioactive seed, and Savi scout ^® radar for management of surgical breast disease

et al. 2020

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“…The device will be more expensive than wire localization and a full cost analysis including the impact of purchase price, radiological efficiency, theatre efficiency, radionuclide injections, patient satisfaction and surgical outcomes is planned. Recent evidence suggests that radioactive seed localization is more cost effective than wire localization [ 9 ], and this saving may be comparable for Magseed surgery.…”

Section: Discussionmentioning

confidence: 99%

Safety and feasibility of breast lesion localization using magnetic seeds (Magseed): a multi-centre, open-label cohort study

Harvey

Lim

Murphy

et al. 2018

Breast Cancer Res Treat

121

123

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PurposeWire localization has several disadvantages, notably wire migration and difficulty scheduling the procedure close to surgery. Radioactive seed localization overcomes these disadvantages, but implementation is limited due to radiation safety requirements. Magnetic seeds potentially offer the logistical benefits and transcutaneous detection equivalence of a radioactive seed, with easier implementation. This study was designed to evaluate the feasibility and safety of using magnetic seeds for breast lesion localization.MethodsA two-centre open-label cohort study to assess the feasibility and safety of magnetic seed (Magseed) localization of breast lesions. Magseeds were placed under radiological guidance into women having total mastectomy surgery. The primary outcome measure was seed migration distance. Secondary outcome measures included accuracy of placement, ease of transcutaneous detection, seed integrity and safety.ResultsTwenty-nine Magseeds were placed into the breasts of 28 patients under ultrasound guidance. There was no migration of the seeds between placement and surgery. Twenty-seven seeds were placed directly in the target lesion with the other seeds being 2 and 3 mm away. All seeds were detectable transcutaneously in all breast sizes and at all depths. There were no complications or safety issues.ConclusionsMagnetic seeds are a feasible and safe method of breast lesion localization. They can be accurately placed, demonstrate no migration in this feasibility study and are detectable in all sizes and depths of breast tissue. Now that safety and feasibility have been demonstrated, further clinical studies are required to evaluate the seed’s effectiveness in wide local excision surgery.

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“…In cases in which ROLL was performed, the tumor-free margin rate was 82.5-90%. Re-excision rates range from 7.2% to 21% with RSL, 12% to 25% with WL and 10.9% with ROLL [7,[12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the nonradioactive inducible magnetic seed system Magseed for preoperative localization of nonpalpable breast lesions – initial clinical experience

Pieszko

Wichtowski

Cieciorowski

et al. 2020

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Radioactive Seed Localization Versus Wire-Guided Localization for Nonpalpable Breast Cancer: A Cost and Operating Room Efficiency Analysis

Cited by 59 publications

References 10 publications

Comparison of wire localization, radioactive seed, and Savi scout ^® radar for management of surgical breast disease

Comparison of wire localization, radioactive seed, and Savi scout ^® radar for management of surgical breast disease

Safety and feasibility of breast lesion localization using magnetic seeds (Magseed): a multi-centre, open-label cohort study

Evaluation of the nonradioactive inducible magnetic seed system Magseed for preoperative localization of nonpalpable breast lesions – initial clinical experience

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Radioactive Seed Localization Versus Wire-Guided Localization for Nonpalpable Breast Cancer: A Cost and Operating Room Efficiency Analysis

Cited by 59 publications

References 10 publications

Comparison of wire localization, radioactive seed, and Savi scout ® radar for management of surgical breast disease

Comparison of wire localization, radioactive seed, and Savi scout ® radar for management of surgical breast disease

Safety and feasibility of breast lesion localization using magnetic seeds (Magseed): a multi-centre, open-label cohort study

Evaluation of the nonradioactive inducible magnetic seed system Magseed for preoperative localization of nonpalpable breast lesions – initial clinical experience

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Comparison of wire localization, radioactive seed, and Savi scout ^® radar for management of surgical breast disease

Comparison of wire localization, radioactive seed, and Savi scout ^® radar for management of surgical breast disease