Radioguidance for nonpalpable primary lesions and sentinel lymph node(s)

Identification of residual breast tumour localization after neo-adjuvant chemotherapy using a radioactive 125 Iodine seed

“…The rate of positive margins in our study was 6%, which is at least comparable to the 8% rate reported by Gray et al (14)(15)(16)(17) and is well below the rate of 50,9% for excisions utilizing wire localization that was reported by Velanovic et al (29), both studies in non-palpable breast tumours. In a another prospective randomized trial of radioactive seed localization versus wire localization of non-palpable breast lesions, Hughes et al (30) found that radioactive seed localization resulted in a 35% relative improvement in the rate of negative margins in the first specimen and a 62% relative improvement in the rate of re-operation for positive margins.…”

“…Radioactive seed localisation was carried out as described by Gray et al (14)(15)(16)) using a titanium seed containing 7 Mbq of Iodine-125 ( 125 I). This radio nuclide has a half-life of 60 days and is a 27 keV source of gamma radiation.…”

“…Although this technique is the current standard technique for pre-operative localization of non-palpable breast lesions there are several disadvantages. (14)(15) After neo-adjuvant chemotherapy an additional problem can be encountered if radiological imaging does not reveal any residual disease -as in case of complete radiologically response -and thus wire localization is not possible. Different therapeutical options ranging from no surgical treatment (only radiotherapy) to quadrantectomy and mastectomy are performed in this situation.…”

“…Implantation -using standard image guided techniques -of a single 125 Iodine ( 125 I) labelled titanium seed before the chemotherapy into the tumour bed puts up with these prerequisites. (15)(16) The 125 Iodine ( 125 I) labelled titanium seed has been described for the localisation of non palpable breast tumours. (14)(15)(16)(17).…”

“…(15)(16) The 125 Iodine ( 125 I) labelled titanium seed has been described for the localisation of non palpable breast tumours. (14)(15)(16)(17). We used the 125 I seed to mark the tumour bed in patients who were planned to receive neo-adjuvant chemotherapy for breast M A N U S C R I P T…”