Evaluating the Introduction of The Use Of Multiple Iodine-125 Seeds in Breast Conservation Surgery
Association of Breast Surgery ePoster Library. Milligan R. 05/15/17; 166324; P044
Mr. Robert Milligan
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Abstract
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Introduction
Radioactive Seed Localisation (RSL) using single iodine-125 seeds has recently been introduced to the United Kingdom with promising initial results. We have recently introduced the use of multiple iodine-125 seeds in breast conservation surgery in lieu of traditional guidewire localisation. Here we present our initial experience.
Methods
Iodine-125 seeds were inserted into patients with ultrasound or stereotactic guidance 7-14 days preoperatively. All specimens underwent radiographic assessment in theatre and iodine seeds were accounted for at all times as per local protocol. Data were collected retrospectively from the electronic records system at our institution from our first multiple seed insertion in December 2015 until October 2016.
Results
A total of 43 procedures were performed on 33 patients undergoing breast conservation surgery using multiple iodine seeds. Of these, 4 patients had bilateral single seed insertion. One patient had bilateral seeds inserted with 2 in the right breast and 1 in the left breast. 25 patients had 2 seeds inserted unilaterally, and 2 patients had 3 seeds inserted unilaterally. 16 therapeutic mammoplasties were performed in 14 patients (two bilateral). 19 dual seed wide local excisions (WLE) and 4 unilateral double WLE were performed. 4/43 (9.3%) procedures required re-excision surgery, although one of these patients opted for completion mastectomy. One patient required intravenous antibiotics for post-operative wound infection and 3 had superficial wound breakdown.
Conclusions
The use of multiple iodine seeds in breast conservation surgery is relatively new technique in our institution, but has acceptable rates of re-excision and complications in our experience.
Radioactive Seed Localisation (RSL) using single iodine-125 seeds has recently been introduced to the United Kingdom with promising initial results. We have recently introduced the use of multiple iodine-125 seeds in breast conservation surgery in lieu of traditional guidewire localisation. Here we present our initial experience.
Methods
Iodine-125 seeds were inserted into patients with ultrasound or stereotactic guidance 7-14 days preoperatively. All specimens underwent radiographic assessment in theatre and iodine seeds were accounted for at all times as per local protocol. Data were collected retrospectively from the electronic records system at our institution from our first multiple seed insertion in December 2015 until October 2016.
Results
A total of 43 procedures were performed on 33 patients undergoing breast conservation surgery using multiple iodine seeds. Of these, 4 patients had bilateral single seed insertion. One patient had bilateral seeds inserted with 2 in the right breast and 1 in the left breast. 25 patients had 2 seeds inserted unilaterally, and 2 patients had 3 seeds inserted unilaterally. 16 therapeutic mammoplasties were performed in 14 patients (two bilateral). 19 dual seed wide local excisions (WLE) and 4 unilateral double WLE were performed. 4/43 (9.3%) procedures required re-excision surgery, although one of these patients opted for completion mastectomy. One patient required intravenous antibiotics for post-operative wound infection and 3 had superficial wound breakdown.
Conclusions
The use of multiple iodine seeds in breast conservation surgery is relatively new technique in our institution, but has acceptable rates of re-excision and complications in our experience.
Introduction
Radioactive Seed Localisation (RSL) using single iodine-125 seeds has recently been introduced to the United Kingdom with promising initial results. We have recently introduced the use of multiple iodine-125 seeds in breast conservation surgery in lieu of traditional guidewire localisation. Here we present our initial experience.
Methods
Iodine-125 seeds were inserted into patients with ultrasound or stereotactic guidance 7-14 days preoperatively. All specimens underwent radiographic assessment in theatre and iodine seeds were accounted for at all times as per local protocol. Data were collected retrospectively from the electronic records system at our institution from our first multiple seed insertion in December 2015 until October 2016.
Results
A total of 43 procedures were performed on 33 patients undergoing breast conservation surgery using multiple iodine seeds. Of these, 4 patients had bilateral single seed insertion. One patient had bilateral seeds inserted with 2 in the right breast and 1 in the left breast. 25 patients had 2 seeds inserted unilaterally, and 2 patients had 3 seeds inserted unilaterally. 16 therapeutic mammoplasties were performed in 14 patients (two bilateral). 19 dual seed wide local excisions (WLE) and 4 unilateral double WLE were performed. 4/43 (9.3%) procedures required re-excision surgery, although one of these patients opted for completion mastectomy. One patient required intravenous antibiotics for post-operative wound infection and 3 had superficial wound breakdown.
Conclusions
The use of multiple iodine seeds in breast conservation surgery is relatively new technique in our institution, but has acceptable rates of re-excision and complications in our experience.
Radioactive Seed Localisation (RSL) using single iodine-125 seeds has recently been introduced to the United Kingdom with promising initial results. We have recently introduced the use of multiple iodine-125 seeds in breast conservation surgery in lieu of traditional guidewire localisation. Here we present our initial experience.
Methods
Iodine-125 seeds were inserted into patients with ultrasound or stereotactic guidance 7-14 days preoperatively. All specimens underwent radiographic assessment in theatre and iodine seeds were accounted for at all times as per local protocol. Data were collected retrospectively from the electronic records system at our institution from our first multiple seed insertion in December 2015 until October 2016.
Results
A total of 43 procedures were performed on 33 patients undergoing breast conservation surgery using multiple iodine seeds. Of these, 4 patients had bilateral single seed insertion. One patient had bilateral seeds inserted with 2 in the right breast and 1 in the left breast. 25 patients had 2 seeds inserted unilaterally, and 2 patients had 3 seeds inserted unilaterally. 16 therapeutic mammoplasties were performed in 14 patients (two bilateral). 19 dual seed wide local excisions (WLE) and 4 unilateral double WLE were performed. 4/43 (9.3%) procedures required re-excision surgery, although one of these patients opted for completion mastectomy. One patient required intravenous antibiotics for post-operative wound infection and 3 had superficial wound breakdown.
Conclusions
The use of multiple iodine seeds in breast conservation surgery is relatively new technique in our institution, but has acceptable rates of re-excision and complications in our experience.
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