|ECR 2019 / C-1559|
|Location of non-palpable breast lesions with magnetic seeds, description of the technique|
Breast cancer represents around 28.5% of all cancers diagnosed in women worldwide. In Spain about 32,825 new breast cancers are diagnosed every year and in 2017, 4,516 new cases were registered in our autonomous region. According to data from this period, the participation in the PDPCM (Programme for Early Detection of Breast Cancer) was around 83.8%, covering 89.6% of our county's population.
Wire marker placement is the commonest method for locating impalpable breast lesions preoperatively. It may cause inconvenience, such as the "accordion effect", wire migration and difficulties in the coordination between surgical and radiological teams. With the advent of magnetic seeds this localization and the workflow afforded have improved these aspects, previously cumbersome to the different teams and professionals involved.
Until 12 December 2017 all impalpable lesions treated in our department were marked with wire markers by stereotaxy before surgery. Malignant impalpable lesions were visible on ultrasound were marked by nuclear medicine (Roll) and sentinel lymph node (Snoll) techniques in another center, as we did not have a nuclear medicine service.
The following types of impalpable lesions may be found: nodular, distorsions, assymetries, and radiological markers of neoadjuvance in patients responding to treatment with subsequent conservative management. Any of these may be marked with Magseed® magnetic seeds following our center's standard procedure. Fig. 2
Some recently published studies confirm that magnetic seeds may be inserted with precision, without significant migrations, and are detectable at different tissue depths. Other authors emphasize that the signals detected from a number of seeds with a margin of <2cm can become a challenge to localize at surgery. They also evaluated the experience of the radiologist and surgeon through a brief questionnaire, concluding that the placement of the seeds is easy according to the radiologists surveyed, and easier than the metallic wire procedure.
Various authors affirm that localizing lesions with magnetic seeds is a reliable, safe and efficient technique, and is even easier when compared to localizing with wire markers, although further studies are needed to ascertain its possible strengths and weaknesses.
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