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在一家癌症专科医院使用磁性标记物对不可触及的乳腺病变进行术前定位。

Preoperative localisation of nonpalpable breast lesions using magnetic markers in a tertiary cancer centre.

机构信息

Radiology Division, "Istituto Nazionale Tumori-IRCCS Fondazione G. Pascale", Naples, Italy.

Breast Surgery Division, "Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale", Naples, Italy.

出版信息

Eur Radiol Exp. 2022 Jul 6;6(1):28. doi: 10.1186/s41747-022-00280-2.

Abstract

BACKGROUND

We retrospectively evaluated safety and performance of magnetic seed localisation of nonpalpable breast lesions.

METHODS

We reviewed records of patients with nonpalpable breast lesions preoperative localised by placing magnetic Magseed® marker between February 2019 and December 2020. During surgery, Sentimag® magnetic probe was used to localise the marker and guide surgery. Safety, lesion identification and excision with tumour with free margins and re-excision rate were assessed.

RESULTS

A total of 77 Magseed® devices were placed into the breasts of 73 patients, 44 under ultrasound and 33 under stereotactic guidance (4 bilateral). All devices were retrieved as were the target lesions. Magnetic marker placement was successful in all cases without any adverse event. Intraoperative identification and excision of the localised lesion were successful in 77 of 77 of cases (100%). In three cases (all of them calcifications with the seed placed under stereotactic guidance), the seed did not reach the exact target position of the biopsy clip; thus, larger excision was needed, with localisation failure attributed to incorrect clip insertion (n = 1) or to clip dislocation (n = 2). Migration of the marker was negligible in all patients. Complete excision after the initial procedure with at least 1-mm disease-free margins was obtained in 74 out of 77 (96.1%) lesions. The re-excision rate was 3 out of 77 (4%).

CONCLUSIONS

Magnetic marker localisation for nonpalpable breast lesions was safe, reliable, and effective in terms of lesion identification, excision with tumour-free margins and re-excision rate.

摘要

背景

我们回顾性评估了磁性种子定位不可触及性乳腺病变的安全性和性能。

方法

我们回顾了 2019 年 2 月至 2020 年 12 月期间通过在不可触及性乳腺病变部位放置磁性 Magseed®标记物进行术前定位的患者记录。在手术期间,使用 Sentimag®磁性探头定位标记物并指导手术。评估安全性、病变识别和切除、肿瘤切缘无肿瘤及再次切除率。

结果

共将 77 个 Magseed®装置放置在 73 例患者的乳房中,44 例在超声引导下,33 例在立体定向引导下(4 例双侧)。所有装置均被取出,目标病变也被切除。所有病例均成功放置磁性标记物,无任何不良事件。77 例(100%)患者均成功在术中识别和切除定位病变。在 3 例(均为种子在立体定向引导下放置的钙化病变)中,种子未到达活检夹的确切目标位置;因此,需要进行更大的切除,定位失败归因于不正确的夹插入(n=1)或夹脱位(n=2)。所有患者的标记物迁移均微不足道。74 例(96.1%)病变在初始手术中完全切除,切缘至少 1mm 无肿瘤。再次切除率为 77 例中的 3 例(4%)。

结论

对于不可触及性乳腺病变,磁性标记物定位是一种安全、可靠、有效的方法,可准确识别病变、切除肿瘤无切缘肿瘤和降低再次切除率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b937/9256869/6b83c865d6f2/41747_2022_280_Fig1_HTML.jpg

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