Magnetic seeds: an attractive localisation option for the management of axillary node positive breast cancer
Association of Breast Surgery ePoster Library. Sinnett V. 05/13/19; 257057; P013
Mrs. Victoria Sinnett
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P013
Topic: Axilla
Introduction:There are 2 indications for accurate removal of a previously identified, involved lymph node: 1) after neoadjuvant chemotherapy (NACT) to ensure that the index node is assessed (targeted axillary dissection), and 2) for women with 1 or 2 abnormal nodes on imaging who may be eligible for sentinel node biopsy (SLNB) as per POSNOC. Dual localisation has an unacceptable false negative rate in the former and marking of the index node is advised. Although a node can be marked prior to NACT, finding that node poses a challenge.Magnetic seed localisation (eg with Magseed) allows for accurate excision of impalpable breast lesions and may also solve the issue of node identification. We aimed to assess the feasibility of Magseed insertion into axillary nodes and accuracy of surgical removal. Methods : A prospective pilot study of 9 patients was undertaken between August and November 2018. Data collected included details of radiology and surgical procedures, clinician satisfaction and pathological outcome. Results: Radiologists reported that the Magseed was easy to insert under ultrasound guidance into the target node (mode 4 out of 5). Eight patients have undergone surgery, 3 after NACT, all with successful removal of the seed and the surgeons were also satisfied (mode 4 out of 5). In all cases the relevant node was identified. Conclusions: Magseed insertion into malignant axillary lymph nodes is feasible and identification of the Magseed node at surgery straightforward. Further evaluation is required to establish utility in facilitating axillary conservation surgery in node positive breast cancer.
Topic: Axilla
Introduction:There are 2 indications for accurate removal of a previously identified, involved lymph node: 1) after neoadjuvant chemotherapy (NACT) to ensure that the index node is assessed (targeted axillary dissection), and 2) for women with 1 or 2 abnormal nodes on imaging who may be eligible for sentinel node biopsy (SLNB) as per POSNOC. Dual localisation has an unacceptable false negative rate in the former and marking of the index node is advised. Although a node can be marked prior to NACT, finding that node poses a challenge.Magnetic seed localisation (eg with Magseed) allows for accurate excision of impalpable breast lesions and may also solve the issue of node identification. We aimed to assess the feasibility of Magseed insertion into axillary nodes and accuracy of surgical removal. Methods : A prospective pilot study of 9 patients was undertaken between August and November 2018. Data collected included details of radiology and surgical procedures, clinician satisfaction and pathological outcome. Results: Radiologists reported that the Magseed was easy to insert under ultrasound guidance into the target node (mode 4 out of 5). Eight patients have undergone surgery, 3 after NACT, all with successful removal of the seed and the surgeons were also satisfied (mode 4 out of 5). In all cases the relevant node was identified. Conclusions: Magseed insertion into malignant axillary lymph nodes is feasible and identification of the Magseed node at surgery straightforward. Further evaluation is required to establish utility in facilitating axillary conservation surgery in node positive breast cancer.
P013
Topic: Axilla
Introduction:There are 2 indications for accurate removal of a previously identified, involved lymph node: 1) after neoadjuvant chemotherapy (NACT) to ensure that the index node is assessed (targeted axillary dissection), and 2) for women with 1 or 2 abnormal nodes on imaging who may be eligible for sentinel node biopsy (SLNB) as per POSNOC. Dual localisation has an unacceptable false negative rate in the former and marking of the index node is advised. Although a node can be marked prior to NACT, finding that node poses a challenge.Magnetic seed localisation (eg with Magseed) allows for accurate excision of impalpable breast lesions and may also solve the issue of node identification. We aimed to assess the feasibility of Magseed insertion into axillary nodes and accuracy of surgical removal. Methods : A prospective pilot study of 9 patients was undertaken between August and November 2018. Data collected included details of radiology and surgical procedures, clinician satisfaction and pathological outcome. Results: Radiologists reported that the Magseed was easy to insert under ultrasound guidance into the target node (mode 4 out of 5). Eight patients have undergone surgery, 3 after NACT, all with successful removal of the seed and the surgeons were also satisfied (mode 4 out of 5). In all cases the relevant node was identified. Conclusions: Magseed insertion into malignant axillary lymph nodes is feasible and identification of the Magseed node at surgery straightforward. Further evaluation is required to establish utility in facilitating axillary conservation surgery in node positive breast cancer.
Topic: Axilla
Introduction:There are 2 indications for accurate removal of a previously identified, involved lymph node: 1) after neoadjuvant chemotherapy (NACT) to ensure that the index node is assessed (targeted axillary dissection), and 2) for women with 1 or 2 abnormal nodes on imaging who may be eligible for sentinel node biopsy (SLNB) as per POSNOC. Dual localisation has an unacceptable false negative rate in the former and marking of the index node is advised. Although a node can be marked prior to NACT, finding that node poses a challenge.Magnetic seed localisation (eg with Magseed) allows for accurate excision of impalpable breast lesions and may also solve the issue of node identification. We aimed to assess the feasibility of Magseed insertion into axillary nodes and accuracy of surgical removal. Methods : A prospective pilot study of 9 patients was undertaken between August and November 2018. Data collected included details of radiology and surgical procedures, clinician satisfaction and pathological outcome. Results: Radiologists reported that the Magseed was easy to insert under ultrasound guidance into the target node (mode 4 out of 5). Eight patients have undergone surgery, 3 after NACT, all with successful removal of the seed and the surgeons were also satisfied (mode 4 out of 5). In all cases the relevant node was identified. Conclusions: Magseed insertion into malignant axillary lymph nodes is feasible and identification of the Magseed node at surgery straightforward. Further evaluation is required to establish utility in facilitating axillary conservation surgery in node positive breast cancer.
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