A combined, totally magnetic technique with a magnetic marker for non-palpable tumour localization and superparamagnetic iron oxide nanoparticles for sentinel lymph node detection in breast cancer surgery
- Resource Type
- Authors
- Staffan Eriksson; Abdi-Fatah Hersi; Andreas Karakatsanis; Fredrik Wärnberg; Joakim Ramos; Shahin Abdsaleh
- Source
- European Journal of Surgical Oncology. 45:544-549
- Subject
- Adult
medicine.medical_specialty
Superparamagnetic iron oxide nanoparticles
Attitude of Health Personnel
medicine.medical_treatment
Sentinel lymph node
Breast Neoplasms
030230 surgery
Mastectomy, Segmental
Ferric Compounds
Lesion
03 medical and health sciences
0302 clinical medicine
Breast cancer
Fiducial Markers
medicine
Breast-conserving surgery
Humans
Aged
Aged, 80 and over
Palpation
Sentinel Lymph Node Biopsy
business.industry
Magnetic marker
General Medicine
Middle Aged
medicine.disease
Surgery
Oncology
030220 oncology & carcinogenesis
Magnets
Nanoparticles
Female
Non palpable
Sentinel Lymph Node
medicine.symptom
Radical resection
business
Learning Curve
- Language
- ISSN
- 0748-7983
Background Surgery for non-palpable breast cancer may often be a challenging procedure. Recently, a magnetic seed (Magseed®) used for tumour localization has been developed. Superparamagnetic iron oxide nanoparticles (SPIO) for sentinel lymph node (SN) detection is a novel tracer that may be injected up to four weeks preoperatively. This study is the first combining the magnetic seed and SPIO. Material and methods Patients planned for breast conserving surgery and SN-biopsy (SNB) were recruited from two units in Sweden. Patients underwent lesion localization with Magseed® and SPIO injection (Magtrace™) by the breast radiologist in the preoperative period. Feasibility of successful lesion localization and excision together with a successful SNB detection was evaluated. Seed migration, number of SNs, specimen volume and calculated resection ratio (CRR) were reported.A survey of the physicians’ experience was conducted. Results Localization was performed at a median of three days before surgery (range 0–25). All 32 patients underwent microscopically radical resection with a CRR of 1.49. No seed migration was noticed. SNB was successful in all patients. A median of two SNs was retrieved. Radiologists and surgeons reported the procedure easy to learn and outperformed guidewire localization in terms of localization and excision time. They thought the technique facilitated planning localization and surgery. Conclusions The combined magnetic technique provided accuracy in tumour localization and SN detection without excess tissue excision and with promising results for flexibility in delivery of care. Larger studies are needed to confirm these findings.