Radioactive seed localization with 125I for nonpalpable lesions prior to breast lumpectomy and/or excisional biopsy: Methodology, safety, and experience of initial year Journal Article
| Authors: | Dauer, L. T.; Thornton, C.; Miodownik, D.; Boylan, D.; Holahan, B.; King, V.; Brogi, E.; Morrow, M.; Morris, E. A.; St. Germain, J. |
| Article Title: | Radioactive seed localization with 125I for nonpalpable lesions prior to breast lumpectomy and/or excisional biopsy: Methodology, safety, and experience of initial year |
| Abstract: | The use of radioactive seed localization (RSL) as an alternative to wire localizations (WL) for nonpalpable breast lesions is rapidly gaining acceptance because of its advantages for both the patient and the surgical staff. This paper examines the initial experience with over 1,200 patients seen at a comprehensive cancer center. Radiation safety procedures for radiology, surgery, and pathology were implemented, and radioactive material inventory control was maintained using an intranet-based program. Surgical probes allowed for discrimination between I seed photon energies from Tc administered for sentinel node testing. A total of 1,127 patients (median age of 57.2 y) underwent RSL procedures with 1,223 seeds implanted. Implanted seed depth ranged from 10.3-107.8 mm. The median length of time from RSL implant to surgical excision was 2 d. The median I activity at time of implant was 3.1 MBq (1.9 to 4.6). The median dose rate from patients with a single seed was 9.5 μSv h and 0.5 μSv h at contact and 1 m, respectively. The maximum contact dose rate was 187 μSv h from a superficially placed seed. RSL performed greater than 1 d before surgery is a viable alternative to WL, allowing flexibility in scheduling, minimizing day of surgery procedures, and improving workflow in breast imaging and surgery. RSL has been shown to be a safe and effective procedure for preoperative localization under mammographic and ultrasound guidance, which can be managed with the use of customized radiation protection controls. © 2013 Health Physics Society. |
| Keywords: | adult; aged; aged, 80 and over; middle aged; retrospective studies; radiation dose; methodology; breast; echomammography; pathology; diagnostic imaging; breast neoplasms; retrospective study; radiation dosage; preoperative period; diagnostic agent; radioactive iodine; iodine radioisotopes; mammography; breast tumor; radioactivity; safety; operating room; segmental mastectomy; mastectomy, segmental; operating rooms; radiation protection; equipment; ultrasonography, mammary; 125i; very elderly |
| Journal Title: | Health Physics |
| Volume: | 105 |
| Issue: | 4 |
| ISSN: | 0017-9078 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2013-10-01 |
| Start Page: | 356 |
| End Page: | 365 |
| Language: | English |
| DOI: | 10.1097/HP.0b013e31829c03e1 |
| PROVIDER: | scopus |
| PUBMED: | 23982612 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 October 2013" - "CODEN: HLTPA" - "Source: Scopus" |
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