Experience with seed localization for nonpalpable breast lesions in a public health care system

Ann Surg Oncol. 2010 Dec;17(12):3241-6. doi: 10.1245/s10434-010-1139-4. Epub 2010 Jun 10.

Abstract

Background: Seed localization uses a radioactive source to identify nonpalpable breast lesions for excision; it is an emerging alternative to wire localization (WL). Previous single health system studies report decreased rates of re-excision and improved patient convenience with this technique. This study is the first to implement this procedure in a public health care delivery system composed of a primarily minority and low-income population.

Materials and methods: A multidisciplinary team was formed to create a protocol for breast seed localization (BSL) and monitor the results. After 50 seed localizations were successfully completed, a retrospective matched-pair analysis with patients who had undergone WL during the same period was performed.

Results: Overall experience with the BSL protocol is reviewed, along with the occurrence of a seed loss. Processes necessary to reactivate the BSL protocol and prevent future losses are delineated. BSL is associated with decreased rates of re-excision and can be successfully implemented in a public health care system.

Conclusions: BSL is an attractive alternative to WL in a high-volume, county-based population. It allows increased efficiency in the operating room and has a low rate of complications. Cautionary measures must be taken to ensure proper seed chain of custody to prevent seed loss.

MeSH terms

  • Breast / diagnostic imaging*
  • Breast / pathology*
  • Breast / surgery
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / surgery
  • Carcinoma, Ductal, Breast / diagnostic imaging
  • Carcinoma, Ductal, Breast / pathology
  • Carcinoma, Ductal, Breast / surgery
  • Carcinoma, Intraductal, Noninfiltrating / diagnostic imaging
  • Carcinoma, Intraductal, Noninfiltrating / pathology
  • Carcinoma, Intraductal, Noninfiltrating / surgery
  • Carcinoma, Lobular / diagnostic imaging
  • Carcinoma, Lobular / pathology
  • Carcinoma, Lobular / surgery
  • Delivery of Health Care*
  • Female
  • Follow-Up Studies
  • Humans
  • Iodine Radioisotopes*
  • Mammography
  • Mastectomy, Segmental
  • Middle Aged
  • Palpation
  • Poverty
  • Radionuclide Imaging
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Iodine Radioisotopes