TY - JOUR
T1 - Pre-operative localization of impalpable breast lesions using iodine 125 seeds
T2 - Placement accuracy and multidisciplinary challenges
AU - Frost, Rosanna
AU - Reed, Anita J.
AU - Dessauvagie, Benjamin Frederik
AU - Taylor, Donna Blanche
PY - 2021/5
Y1 - 2021/5
N2 - Introduction: The number of impalpable breast lesions requiring pre-operative lesion localization (PLL) continues to increase. The use of Radio-guided Occult Lesion Localization with Iodine 125 Seeds (ROLLIS) offers multiple benefits for the multidisciplinary team (MDT), but is not without challenges. Aims: The aims of this audit were to review our multidisciplinary team's experience following introduction of ROLLIS as standard of care for PLL, identify challenges and evaluate seed placement accuracy (SPA). Results/outcomes: Over a nineteen month period, 327 seeds were inserted: 96% of single seed localizations were within 10 mm, 91% within 5 mm and 42% within or in contact with the lesion (or marker clip surrogate) on post-insertion two view mammography. Each component of the MDT reported on benefits of the ROLLIS program and challenges faced. Examples included: an undetectable seed in the operating room, a seed damaged in pathology during specimen processing, suboptimal seed position requiring hook-wire localization (HWL) and delayed seed removal in a patient who initially refused to return for surgery. Conclusion: ROLLIS results in high seed placement accuracy. Despite clear advantages, use of ROLLIS presents some multidisciplinary challenges. Robust patient information, training of new staff and adherence to strict policies and protocols are required to ensure safe delivery of a ROLLIS program.
AB - Introduction: The number of impalpable breast lesions requiring pre-operative lesion localization (PLL) continues to increase. The use of Radio-guided Occult Lesion Localization with Iodine 125 Seeds (ROLLIS) offers multiple benefits for the multidisciplinary team (MDT), but is not without challenges. Aims: The aims of this audit were to review our multidisciplinary team's experience following introduction of ROLLIS as standard of care for PLL, identify challenges and evaluate seed placement accuracy (SPA). Results/outcomes: Over a nineteen month period, 327 seeds were inserted: 96% of single seed localizations were within 10 mm, 91% within 5 mm and 42% within or in contact with the lesion (or marker clip surrogate) on post-insertion two view mammography. Each component of the MDT reported on benefits of the ROLLIS program and challenges faced. Examples included: an undetectable seed in the operating room, a seed damaged in pathology during specimen processing, suboptimal seed position requiring hook-wire localization (HWL) and delayed seed removal in a patient who initially refused to return for surgery. Conclusion: ROLLIS results in high seed placement accuracy. Despite clear advantages, use of ROLLIS presents some multidisciplinary challenges. Robust patient information, training of new staff and adherence to strict policies and protocols are required to ensure safe delivery of a ROLLIS program.
KW - Breast intervention
KW - Impalpable breast lesion
KW - Iodine-125 seed
KW - Multidisciplinary team
KW - Pre-operative lesion localization
UR - http://www.scopus.com/inward/record.url?scp=85098526866&partnerID=8YFLogxK
U2 - 10.1016/j.clinimag.2020.12.008
DO - 10.1016/j.clinimag.2020.12.008
M3 - Article
C2 - 33387917
AN - SCOPUS:85098526866
VL - 73
SP - 124
EP - 133
JO - Clinical Imaging
JF - Clinical Imaging
SN - 0899-7071
ER -