A german pilot study comparing standard wire localization with magnetic seed localization for non-palpable breast lesions

Background:

Exact tumor localization of non-palpable breast lesions is necessary to make sure the correct lesion is removed and can be done by wire localization or through intraoperative-ultrasound. While both methods are well established, they come with disadvantages like logistic and migration issues and in the case of intraoperative-ultrasound non-identification of lesions increasing operating time.

Methods:

We compared 28 patients who underwent breast-conserving surgery for a non-palpable lesion. 14 patients were assigned at surgeons' choice to receive magnetic seed localization and 14 patients received standard wire localization. All patients were asked to complete the QUIPS pain questionnaire directly following the localization procedure. Primary outcome was operating time from incision to removal of the tumor, secondary outcomes patient pain levels.

Results:

Mean age was 52 (SD 10) years in the seed arm, 55 (SD 13) years in the wire arm. Median time from skin incision to tumor extraction was 18 (IQR 11 – 24) minutes in the wire group and 14 (IQR 11 – 18) minutes in the seed group (p = 0.53). Patients in the wire group significantly more often reported pain during coughing or breathing (57.1% versus 0.0%, p < 0.001) and significantly more pain during movement (71.4% versus 0.0% p = 0.002) compared to the seed group.

Conclusions:

Despite seed localization being a new method surgical time was similar and did not differ significantly between both groups. Seed localization could allow for time savings once established while increasing patient comfort and decreasing organizational burden caused by the need to schedule wire localizations on the day of surgery.