Patient and clinician satisfaction and clinical outcomes of Magseed compared with wire-guided localisation for impalpabl
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ORIGINAL ARTICLE
Patient and clinician satisfaction and clinical outcomes of Magseed compared with wire‑guided localisation for impalpable breast lesions Aikaterini E. Micha1 · Victoria Sinnett1 · Kate Downey1,3 · Steve Allen1,3 · Briony Bishop3,4 · Lauren R. Hector1 · Elaine P. Patrick1 · Ruth Edmonds3 · Peter A. Barry1,2 · Katherine D. C. Krupa1 · Jennifer E. Rusby1,2 Received: 27 March 2020 / Accepted: 17 August 2020 © The Author(s) 2020
Abstract Background Guide-wire localisation remains the most commonly used technique for localisation of impalpable breast lesions in the UK. One alternative is magnetic seed localisation. We aimed to investigate patient and clinician satisfaction in two consecutive cohorts, describe re-excision and positive margin rates, and explore reasons for positive margins and the implications for localisation techniques. Methods A single-institution prospective service evaluation of two cohorts of consecutive cases of wire and then Magseed localisation was carried out. Data were collected on patient and clinician satisfaction, clinico-pathological findings, and causes of involved margins. T tests were used to compare continuous variables and Chi-squared test for satisfaction outcomes. Results 168 consecutive cases used wire-guided localisation (WGL) and 128 subsequent cases used Magseeds. Patients reported less anxiety between localisation and surgery in the Magseed group, and clinicians reported greater ease of use of Magseeds. There were no differences in lesion size, surgical complexity, or re-excision rate between the groups. In a subset of patients receiving standard wide local excision (i.e., excluding mammoplasties), the impact on margin involvement was investigated. There was no significant difference in radiological under-sizing or accuracy of localisation. However, specimen weight and eccentricity of the lesion were statistically significantly lower in the Magseed group. Despite this, re-excision rates were not significantly different (p = 0.4). Conclusions This is the first large study of satisfaction with localisation and showed clinician preference for Magseed and a reduction in patient anxiety. It also demonstrated similar positive margin rates despite smaller specimen weights in the Magseed group. Magnetic seed localisation offers an acceptable clinical alternative to guide wire localisation. The impact on local service provision should also be considered. Keywords Wide local excision · Breast cancer · Magnetic seed · Magseed · Localisation
Introduction
Part of this work has been presented as an oral presentation at the Association of Breast Surgery Annual Meeting, Glasgow 2019 and published in abstract form [1, 2]. * Jennifer E. Rusby [email protected] 1
Royal Marsden NHS Foundation Trust, Royal Marsden Hospital, Downs Road, Sutton SM2 5PT, Surrey, UK
2
Institute for Cancer Research, Sutton, UK
3
Royal Marsden NHS Foundation Trust, London, UK
4
Bedfordshire Hospitals NHS Trust, South Wing, Kempston Rd, Bedford MK42 9DJ, UK
Approximately o
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