Wire- and magnetic-seed-guided localization of impalpable breast lesions: iBRA-NET localisation study

iBRA-NET Localisation Study collaborative

Research output: Contribution to journalArticle (Academic Journal)peer-review

17 Citations (Scopus)
22 Downloads (Pure)

Abstract

BACKGROUND: Wire localization is historically the most common method for guiding excision of non-palpable breast lesions, but there are limitations to the technique. Newer technologies such as magnetic seeds may allow some of these challenges to be overcome. The aim was to compare safety and effectiveness of wire and magnetic seed localization techniques.

METHODS: Women undergoing standard wire or magnetic seed localization for non-palpable lesions between August 2018 and August 2020 were recruited prospectively to this IDEAL stage 2a/2b platform cohort study. The primary outcome was effectiveness defined as accurate localization and removal of the index lesion. Secondary endpoints included safety, specimen weight and reoperation rate for positive margins.

RESULTS: Data were accrued from 2300 patients in 35 units; 2116 having unifocal, unilateral breast lesion localization. Identification of the index lesion in magnetic-seed-guided (946 patients) and wire-guided excisions (1170 patients) was 99.8 versus 99.1 per cent (P = 0.048). There was no difference in overall complication rate. For a subset of patients having a single lumpectomy only for lesions less than 50 mm (1746 patients), there was no difference in median closest margin (2 mm versus 2 mm, P = 0.342), re-excision rate (12 versus 13 per cent, P = 0.574) and specimen weight in relation to lesion size (0.15 g/mm2versus 0.138 g/mm2, P = 0.453).

CONCLUSION: Magnetic seed localization demonstrated similar safety and effectiveness to those of wire localization. This study has established a robust platform for the comparative evaluation of new localization devices.

Original languageEnglish
Pages (from-to)274-282
Number of pages9
JournalBritish Journal of Surgery
Volume109
Issue number3
Early online date28 Jan 2022
DOIs
Publication statusPublished - 1 Mar 2022

Bibliographical note

Publisher Copyright:
© 2022 The Author(s). Published by Oxford University Press on behalf of BJS Society Ltd.

Keywords

  • Aged
  • Breast Neoplasms/pathology
  • Female
  • Fiducial Markers
  • Humans
  • Magnets/adverse effects
  • Margins of Excision
  • Mastectomy, Segmental/adverse effects
  • Middle Aged
  • Neoplasm Staging
  • Postoperative Complications
  • Prospective Studies

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