保乳手术和切除不可触及病变中使用手术标记导航系统：西班牙首例单中心经验。

Surgical marker navigation system in breast conserving surgery and excision of non-palpable lesions: first Spanish single-center experience.

机构信息

General and Digestive Surgery Department, University Hospital Ramón y Cajal, Ctra. de Colmenar Viejo, Km. 9,100, 28034, Madrid, Spain.

Radiology Department, University Hospital Ramón y Cajal, Madrid, Spain.

出版信息

Breast Cancer Res Treat. 2024 Oct;207(3):533-540. doi: 10.1007/s10549-024-07382-y. Epub 2024 May 28.

DOI:10.1007/s10549-024-07382-y

PMID:38806876

Abstract

BACKGROUND

Due to the establishment of screening mammography for breast cancer detection, the number of non-palpable lesions has increased. Thus, an optimal localization system is mandatory for the excision of non-palpable breast tumors.

OBJECTIVE

The aim of the study is to report the feasibility Surgical Marker Navigation (SMN) system Sirius Pintuition® for the excision of non-palpable breast tumors and non-palpable axillary lymph nodes.

METHODS

A retrospective observational study of patients undergoing breast-conserving surgery and lymph node excision guided by SMN between December 2022 and May 2023 was performed.

RESULTS

A total of 84 patients underwent excision of non-palpable breast tumors (77; 91.7%) or non-palpable axillary lymph-nodes (7; 8.3%) using SMN. In total, 94 markers were placed, in 74 patients (88.1%) only one marker was placed, whereas in 10 patients (11.9%) two markers were placed to correctly localize the lesion in the operating room. Most markers were placed using ultrasonographic guidance (69; 82.1%). Seventy-seven patients underwent breast-conserving surgery (91.7%) and 7 (8.3%) lymph node excision. In 10 cases (11.9%), the marker was accidentally displaced during surgery due to the use of magnetized instruments, although the specimen could be removed. In sum, all the markers were removed from the patients, although the marker retrieval rate, as we defined it (percentage of patients in whom the initial excised specimen contained the marker divided by the total number of patients), was 88.1%.

CONCLUSION

The use of Sirius Pintuition® SMN for non-palpable breast tumors and non-palpable lymph nodes is feasible, with a retrieval rate of 88.1%.

摘要

背景

由于乳腺癌检测筛查的建立，触诊阴性病变的数量有所增加。因此，对于触诊阴性乳腺肿瘤的切除，需要有一个最佳的定位系统。

目的

本研究旨在报告使用 Surgical Marker Navigation (SMN) 系统 Sirius Pintuition®切除触诊阴性乳腺肿瘤和触诊阴性腋窝淋巴结的可行性。

方法

对 2022 年 12 月至 2023 年 5 月间接受 SMN 引导的保乳手术和淋巴结切除的患者进行回顾性观察性研究。

结果

共有 84 例患者接受了触诊阴性乳腺肿瘤（77 例；91.7%）或触诊阴性腋窝淋巴结（7 例；8.3%）的切除，共放置了 94 个标记物，其中 74 例患者（88.1%）仅放置了 1 个标记物，10 例患者（11.9%）放置了 2 个标记物，以在手术室正确定位病变。大多数标记物是在超声引导下放置的（69 例；82.1%）。77 例患者接受了保乳手术（91.7%），7 例患者（8.3%）进行了淋巴结切除。在 10 例（11.9%）中，由于使用了磁化器械，标记物在手术中意外移位，尽管标本仍能取出。总的来说，所有标记物都从患者体内取出，尽管我们定义的标记物回收率（初始切除标本中包含标记物的患者百分比除以患者总数）为 88.1%。