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.
Rao
Roshni
R
Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA. Roshni.Rao@UTSouthwestern.edu
Moldrem
Amy
A
Sarode
Venetia
V
White
John
J
Amen
Matt
M
Rao
Madhu
M
Andrews
Valerie
V
Euhus
David
D
Radford
Lee
L
Ulissey
Michael
M
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