Wireless localisation of breast lesions with MagSeed. A radiological perspective of 300 cases
Fotios Constantinidis, Sophia Sakellariou, Sau Lee Chang, Svetlana Linder, Barbara MacPherson, Subodh Seth, Nicola Gill, Archana Seth
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.