Schermers B, van der Hage J A, Loo C E, Vrancken Peeters M T F D, Winter-Warnars H A O, van Duijnhoven F, Ten Haken B, Muller S H, Ruers T J M
The Netherlands Cancer Institute, Department of Surgery, The Netherlands; University of Twente, MIRA Institute, The Netherlands.
The Netherlands Cancer Institute, Department of Surgery, The Netherlands.
Breast. 2017 Jun;33:50-56. doi: 10.1016/j.breast.2017.03.003. Epub 2017 Mar 7.
Accurate tumour localisation is essential for breast-conserving surgery of non-palpable tumours. Current localisation technologies are associated with disadvantages such as logistical challenges and migration issues (wire guided localisation) or legislative complexities and high administrative burden (radioactive localisation). We present MAgnetic MArker LOCalisation (MaMaLoc), a novel technology that aims to overcome these disadvantages using a magnetic marker and a magnetic detection probe. This feasibility study reports on the first experience with this new technology for breast cancer localisation.
Fifteen patients with unifocal, non-palpable breast cancer were recruited. They received concurrent placement of the magnetic marker in addition to a radioactive iodine seed, which is standard of care in our clinic. In a subset of five patients, migration of the magnetic marker was studied. During surgery, a magnetic probe and gammaprobe were alternately used to localise the markers and guide surgery. The primary outcome parameter was successful transcutaneous identification of the magnetic marker. Additionally, data on radiologist and surgeon satisfaction were collected.
Magnetic marker placement was successful in all cases. Radiologists could easily adapt to the technology in the clinical workflow. Migration of the magnetic marker was negligible. The primary endpoint of the study was met with an identification rate of 100%. Both radiologists and surgeons reflected that the technology was intuitive to use and that it was comparable to radioactive iodine seed localisation.
Magnetic marker localisation for non-palpable breast cancer is feasible and safe, and may be a viable non-radioactive alternative to current localisation technologies.
准确的肿瘤定位对于不可触及肿瘤的保乳手术至关重要。当前的定位技术存在诸多缺点，如后勤挑战和移位问题（金属丝引导定位），或立法复杂性和高行政负担（放射性定位）。我们提出了磁性标记定位（MaMaLoc），这是一种旨在利用磁性标记和磁性检测探头克服这些缺点的新技术。本可行性研究报告了这项乳腺癌定位新技术的首次应用经验。
招募了15例单灶性、不可触及乳腺癌患者。除了放射性碘籽源外，他们还同时植入了磁性标记，放射性碘籽源是我们诊所的标准治疗方法。在5例患者的亚组中，研究了磁性标记的移位情况。手术过程中，交替使用磁性探头和γ探头定位标记并指导手术。主要结局参数是成功经皮识别磁性标记。此外，收集了放射科医生和外科医生满意度的数据。
所有病例中磁性标记植入均成功。放射科医生能够轻松地在临床工作流程中适应该技术。磁性标记的移位可忽略不计。研究的主要终点达成，识别率为100%。放射科医生和外科医生均反映该技术使用直观，且与放射性碘籽源定位相当。
不可触及乳腺癌的磁性标记定位是可行且安全的，可能是当前定位技术的一种可行的非放射性替代方法。
