The standard treatment for early breast cancer with node-negative axilla is wide local excision (WLE) and sentinel lymph node biopsy (SNB). Guide-wire WLE for impalpable cancers poses various challenges. The use of magnetic seeds has been adopted as an alternative solution. Difficult detectability, magnetic interference with metallic instruments/MRI, and recalibration remain open issues. The aims of the study are: Compare oncological clearance of cancer between magnetic and nonmagnetic localization seeds; Demonstrate a good identification rate of SNB using a non-radioisotope fluorescent dye. Confirm good node detection rate with the ICG regardless of patients’ BMI. Results The identification rate of SNB with ICG dye was 100% despite high BMI. Also, BMI has not affected the number of nodes retrieved (average number of SNB was 2, similar to other case series). A total of 5 of the patients localized with SAVI SCOUT had positive margins (10%) compared with 6 localized with magnetic seed (12%). The re-excision rate using SAVI SCOUT/Magseed is not statistically significant. Compared with guide wire, the use of SAVI SCOUT reduced the re-excision rate by 50% in our case series (15% vs 10%).
Conclusions: Non-magnetic localization of impalpable breast cancers showed a good detection rate with adequate margins clearance (10% re-excision rate, compared with 17.2% UK average). The use of ICG in SNB (with blue dye) is associated with an identification rate of 100% regardless of high BMI. Preoperative admission and preparation for surgery are streamlined by avoiding the need for wire localization and radioisotope injection.
52 UK Experience of Non-Radioisotope, Non-Magnetic Guided Breast Wide Local Excision and Sentinel Node Biopsy (cancernetwork.com)
