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磁性种子定位在不可触及乳腺病变切除中的初步经验:在爱尔兰的一家三级转诊中心完成的前 100 例。

Initial experience of magnetic seed localization for impalpable breast lesion excision: First 100 cases performed in a single Irish tertiary referral centre.

机构信息

Department of Breast Surgery, Mater Mistericordiae University Hospital, Eccles St, Dublin 7, Ireland.

Department of Radiology, Mater Mistericordiae University Hospital, Eccles St, Dublin 7, Ireland.

出版信息

Surgeon. 2022 Jun;20(3):e36-e42. doi: 10.1016/j.surge.2021.02.010. Epub 2021 Apr 8.

Abstract

INTRODUCTION

Wire guided localization has been widely utilized as the standard method of pre-operative localization of breast lesions. Magnetic seeds were developed to counter some of the disadvantages associated with wires. This aim of this study was to assess outcomes following the introduction of magnetic seeds at a tertiary specialist breast centre.

METHODS

A retrospective review of a prospective database of the first 100 patients who underwent magnetic seed (Magseed) guided breast surgery between November 2018 and November 2019. Data was collected from 17 wire guided cases completed during the trial phase for comparison. The primary outcome measures were successful excision of index lesion and retrieval of the magnetic seed. Secondary outcomes analyzed included time ready for theatre, post-operative complications and breast margin re-excision rate.

RESULTS

Of these 100 cases, 85 patients underwent Magseed guided wide local excision for invasive or in-situ carcinoma and 15 underwent Magseed guided diagnostic excision. The primary lesion was excised, and Magseed was retrieved in all 100 cases. 54% of patients were ready to proceed as the first scheduled theatre case of the day, compared to 0% of wire-guided cases. Amongst therapeutic Magseed guided cases, the re-excision rate for margin clearance was 9.4%.

CONCLUSION

Magseed guided breast excision is a new technology that has been implemented with relative ease in our unit. We have shown that magnetic seed guided surgery reliably localizes lesions, is associated with low re-excision rates without an increase in patient morbidity or mortality and results in improvements in theatre planning and efficiency.

摘要

简介

导丝定位已被广泛应用于乳房病变的术前定位标准方法。磁性种子的开发是为了克服与导丝相关的一些缺点。本研究旨在评估在一家三级专科乳腺中心引入磁性种子后的结果。

方法

对 2018 年 11 月至 2019 年 11 月期间接受磁性种子(Magseed)引导下乳腺手术的前 100 例患者的前瞻性数据库进行回顾性分析。为了比较,收集了试验阶段完成的 17 例导丝引导病例的数据。主要结局指标为索引病变的成功切除和磁性种子的回收。分析的次要结局包括准备手术的时间、术后并发症和乳房边缘再次切除率。

结果

这 100 例患者中,85 例行 Magseed 引导广泛局部切除术治疗浸润性或原位癌,15 例行 Magseed 引导诊断性切除术。100 例患者均成功切除了原发性病变并回收了 Magseed。与导丝引导病例相比,54%的患者可作为当天第一台预约手术患者准备就绪。在治疗性 Magseed 引导病例中,边缘清除的再次切除率为 9.4%。

结论

Magseed 引导的乳腺切除术是一种新技术,在我们的单位中已经相对容易地实施。我们已经证明,磁性种子引导手术可靠地定位病变,与低再切除率相关,不会增加患者的发病率或死亡率,并改善手术室规划和效率。

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