Wireless localisation of breast lesions with MagSeed. A radiological perspective of 300 cases
Abstract
Objectives:
The purpose of this article is to review the technical and radiological aspects of MagSeed® localisation, to assess its accuracy based on post-localisation mammograms and excision specimen X-rays and to discuss the radiological experience of our institutions.
Methods:
Two-year data were collected retrospectively from three NHS boards from the West of Scotland. A total of 309 MagSeeds® were inserted under mammographic or ultrasonographic guidance in 300 women with unifocal, multifocal and/or bilateral breast lesions at the day of surgery or up to 30 days prior to it. Radiological review of post-localisation mammograms and intraoperative specimen X-rays as well as a review of the surgical outcomes were performed to assess the accuracy and efficacy of the method. Our experience relating to the technique’s strengths and downsides were also noted.
Results:
The MagSeeds® were inserted on average 7.2 days before surgery. The localisation technique was straight forward for the radiologists. In 99% of the cases, the MagSeed® was successfully deployed and 100% of the successfully localised lesions were excised at surgery. There was no difference in the accuracy of the localisation whether this was mammographically or ultrasonographically guided. On post-localisation mammograms, the MagSeed® was radiologically accurately positioned in 97.3% of the cases. No delayed MagSeed® migration was observed. On the specimen X-rays, the lesion was centrally positioned in 45.1%, eccentric within more than 1 mm from the margin in 35.7% and in 14.8% it was at the specimen’s margin. The re-excision rate was 18.3%.
Conclusion:
The MagSeed® is an accurate and reliable localisation method in breast conserving surgery with good surgical outcomes.
Advances in knowledge:
To our knowledge, the radiological aspects of MagSeed® localisation have not been widely described in peer-reviewed journals thus far.
REFERENCES
1. . A modified needle-hookwire technique to simplify preoperative localization of occult breast lesions. Radiology 1980; 134(3):
781 . doi: https://doi.org/10.1148/radiology.134.3.73552352. . Localization techniques for guided surgical excision of non-palpable breast lesions. Cochrane Database Syst Rev 2015; 12:
CD009206 . doi: https://doi.org/10.1002/14651858.CD009206.pub23. . Radioguided surgery of occult breast lesions. Eur J Cancer 1998; 34: 204–5. doi: https://doi.org/10.1016/s0959-8049(97)00376-6
4. . Preoperative radioactive seed localization for nonpalpable breast lesions: technique, pitfalls, and solutions. Radiographics 2015; 35: 1319–34. doi: https://doi.org/10.1148/rg.2015140293
5. . The introduction of radioactive seed localisation improves the oncological outcome of image guided breast conservation surgery. Breast 2017; 36: 49–53:
S0960-9776(17)30576-3 . doi: https://doi.org/10.1016/j.breast.2017.09.0046. . Safety and efficacy of radioactive seed localization with i-125 prior to lumpectomy and/or excisional biopsy. Eur J Radiol 2013; 82: 1453–57:
S0720-048X(13)00203-9 . doi: https://doi.org/10.1016/j.ejrad.2013.04.0087.
De Cicco C, , Gatti G, , Luini G, , Radioguided Surgery . Radioguided Occult Lesion Localization in the Breast. New York: Springer. 2008. doi: https://doi.org/10.1007/978-0-387-38327-98. . A prospective, single arm, multi-site, clinical evaluation of a nonradioactive surgical guidance technology for the location of nonpalpable breast lesions during excision. Ann Surg Oncol 2016; 23: 3168–74. doi: https://doi.org/10.1245/s10434-016-5405-y
9. . Beyond wires and seeds: reflector-guided breast lesion localization and excision. Radiology 2017; 284: 365–71. doi: https://doi.org/10.1148/radiol.2017161661
10. . Savi scout® radar localisation of non-palpable breast lesions: systematic review and pooled analysis of 842 cases. Anticancer Res 2020; 40: 3633–43. doi: https://doi.org/10.21873/anticanres.14352
11. . P152. a dgh’s experience using magseed as a localisation tool for impalpable breast lesions. European Journal of Surgical Oncology 2019; 45: 923–24. doi: https://doi.org/10.1016/j.ejso.2019.01.172
12. . Initial clinical experience with an inducible magnetic seed system for preoperative breast lesion localization. AJR Am J Roentgenol 2018; 210: 913–17. doi: https://doi.org/10.2214/AJR.17.18345
13. . 25. magseed for localisation of impalpable breast cancers is associated with high patient satisfaction and lower re-excision rates. European Journal of Surgical Oncology 2018; 44: 1839. doi: https://doi.org/10.1016/j.ejso.2018.10.030
14. . P037. magseed localisation of non palpable breast cancer. is the future magnetic? European Journal of Surgical Oncology 2019; 45: 895–96. doi: https://doi.org/10.1016/j.ejso.2019.01.059
15. . Safety and feasibility of breast lesion localization using magnetic seeds (magseed): a multi-centre, open-label cohort study. Breast Cancer Res Treat 2018; 169: 531–36. doi: https://doi.org/10.1007/s10549-018-4709-y
16. . A prospective, single-arm, multicentre clinical evaluation of a new localisation technique using non-radioactive magseeds for surgery of clinically occult breast lesions. Clin Radiol 2019; 74: 974.
S0009-9260(19)30533-1 . doi: https://doi.org/10.1016/j.crad.2019.08.01817. . Evolving role of magseed in wireless localization of breast lesions: systematic review and pooled analysis of 1,559 procedures. Anticancer Res 2020; 40: 1809–15. doi: https://doi.org/10.21873/anticanres.14135
18. . Evaluation of a nonradioactive magnetic marker wireless localization program. AJR Am J Roentgenol 2018; 211: 940–45. doi: https://doi.org/10.2214/AJR.18.19637
19. . P006: the triple effect of the magseed for localisation of impalpable breast cancer: significant reduction in re-excision rate, cost saving by reducing further surgery and high patient satisfaction. European Journal of Surgical Oncology 2020; 46:
e12 . doi: https://doi.org/10.1016/j.ejso.2020.03.04520. . Magseed for wide local excision surgery. European Journal of Surgical Oncology 2018; 44: 918. doi: https://doi.org/10.1016/j.ejso.2018.02.241
21.
West of Scotland Cancer Network . Final Published Breast Cancer MCN Audit Report v1.0. West of Scotland Cancer Network, UK. 2020. Available from: https://www.woscan.scot.nhs.uk/wp-content/uploads/Final_Published_QPI-Audit-Report-v0.1_140120.pdf (accessed14 Jan 2020 )22. . Multicentre evaluation of magnetic technology for localisation of non-palpable breast lesions and targeted axillary nodes. ANZ J Surg 2021; 91: 2411–17. doi: https://doi.org/10.1111/ans.17108
23. . Early budget impact analysis on magnetic seed localization for non-palpable breast cancer surgery. PLoS One 2020; 15(5):
e0232690 . doi: https://doi.org/10.1371/journal.pone.023269024. . The bottom line for lesion localization in breast cancer. Breast Cancer Res Treat 2020; 182: 523–25. doi: https://doi.org/10.1007/s10549-020-05735-x