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


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.
Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA. Roshni.Rao@UTSouthwestern.edu
Roshni
R
Rao
Amy
A
Moldrem
Venetia
V
Sarode
John
J
White
Matt
M
Amen
Madhu
M
Rao
Valerie
V
Andrews
David
D
Euhus
Lee
L
Radford
Michael
M
Ulissey
D001940:Breast / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D003695:Delivery of Health Care; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes; D008327:Mammography; D015412:Mastectomy, Segmental; D008875:Middle Aged; D010173:Palpation; D011203:Poverty; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D016896:Treatment Outcome
D007457:Iodine Radioisotopes