title: Iodine-125 seeds to guide removal of impalpable breast lesions: radio-guided occult lesion localization - a pilot study.
abstract: BACKGROUND
  The aim of this study was to confirm that radio-guided occult lesion localization using low activity iodine 125 (I-125) seeds (ROLLIS) could be safely and accurately used for localization and guided excision of impalpable breast lesions in different multidisciplinary settings and to prepare staff for a randomized controlled trial.
  
  
  METHODS
  Preoperative image-guided localization of 102 lesions using one or two I-125 seeds with hook-wire back-up was performed in 99 participants at two tertiary hospitals. Preoperative core biopsy in 24 lesions was benign or indeterminate (Group A) and malignant in 78 lesions (Group B). Imaging and histopathology findings and re-excision rates were recorded. Training requirements for new staff and seed handling protocols were refined.
  
  
  RESULTS
  All seeds and lesions were successfully removed. In five of 23 Group A participants, malignancy on final pathology required definitive surgery for positive margins. The re-excision rate in Group B was 17%. Overall re-excision rate was 18%. Thirty-seven clinical staff members were trained. Sentinel node localization was successful in all 76 cases. Seeds of low activity were successfully used.
  
  
  CONCLUSIONS
  The ROLLIS technique using a lower dose (∼2 MBq) seed is safe, effective and can easily be adopted in a large multi-disciplinary setting.
authors.affiliation: Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.|School of Surgery, University of Western Australia, Perth, Western Australia, Australia.|BreastScreen WA, Perth, Western Australia, Australia.
authors.forename: Anita G
authors.initials: AG
authors.lastname: Bourke
authors.affiliation: School of Surgery, University of Western Australia, Perth, Western Australia, Australia.|BreastScreen WA, Perth, Western Australia, Australia.|Royal Perth Hospital, Perth, Western Australia, Australia.
authors.forename: Donna B
authors.initials: DB
authors.lastname: Taylor
authors.affiliation: Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.|School of Physics, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Eliza
authors.initials: E
authors.lastname: Westcott
authors.affiliation: Royal Perth Hospital, Perth, Western Australia, Australia.
authors.forename: Max
authors.initials: M
authors.lastname: Hobbs
authors.affiliation: School of Surgery, University of Western Australia, Perth, Western Australia, Australia.|Royal Perth Hospital, Perth, Western Australia, Australia.
authors.forename: Christobel
authors.initials: C
authors.lastname: Saunders
mesh_terms: D001315:Australia / Q000453:epidemiology; D001940:Breast / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000378:metabolism*; D008875:Middle Aged; D010865:Pilot Projects; D011877:Radionuclide Imaging / Q000295:instrumentation / Q000379:methods*; D019275:Radiopharmaceuticals; D016032:Randomized Controlled Trials as Topic
chemical_list: D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; C000614960:Iodine-125
keywords: breast; cancer; iodine-125 seed; localization; radio-guided