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Preoperative Radioactive Seed Localization
Wendie A. Berg, MD, PhD, FACR, FSBI; Reni Butler, MD
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KEY FACTS

  • Terminology

    • Preprocedure

      • Procedure

        • Post Procedure

          • Outcomes

            TERMINOLOGY

            • Abbreviations

              • Radioactive seed localization (RSL)
            • Definitions

              • Image-guided placement of I-125 seed into breast lesion prior to surgical excision guided by gamma probe
              • 0.200 mCi I-125 assayed activity when manufactured
              • 35.5 keV gamma; 27 keV and 31.4 keV x-ray emissions
              • 59.4 day half-life; 0.25-mm lead reduces exposure > 99%
              • Silver iodide-coated seed in titanium capsule, 4.5 x 0.8 mm
              • Survey meter: Geiger-Müeller gamma emission detector
              • Gamma probe: Handheld, for intraoperative use

            PREPROCEDURE

            • Indications

              • Contraindications

                • Preprocedure Imaging

                  • Getting Started

                    PROCEDURE

                    • Patient Position/Location

                      • Procedure Steps

                        • Findings and Reporting

                          • Alternative Procedures/Therapies

                            POST PROCEDURE

                            • Expected Outcome

                              • Things to Do

                                • Things to Avoid

                                  OUTCOMES

                                  • Problems

                                    • Complications

                                      Selected References

                                      1. Da Silva M et al: Bracketed radioactive seed localization vs bracketed wire-localization in breast surgery. Breast J. 24(2):161-66, 2018
                                      2. Stelle L et al: Radioactive seed localization versus wire localization for nonpalpable breast lesions: a two-year initial experience at a large community hospital. Ann Surg Oncol. 25(1):131-36, 2018
                                      3. Xu XJ et al: An updated meta-analysis of radioactive seed localization versus wire-guided localization in the treatment of nonpalpable breast lesions. Breast J. 24(4):673-75, 2018
                                      4. Hayes MK: Update on Preoperative Breast Localization. Radiol Clin North Am. 55(3):591-603, 2017
                                      5. Tran VT et al: Comparative Evaluation of Iodine-125 Radioactive Seed Localization and Wire Localization for Resection of Breast Lesions. Can Assoc Radiol J. 68(4):447-455, 2017
                                      6. Bloomquist EV et al: A Randomized Prospective Comparison of Patient-Assessed Satisfaction and Clinical Outcomes with Radioactive Seed Localization versus Wire Localization. Breast J. 22(2):151-7, 2016
                                      7. Dryden MJ et al: Imaging Factors That Influence Surgical Margins After Preoperative 125I Radioactive Seed Localization of Breast Lesions: Comparison With Wire Localization. AJR Am J Roentgenol. 206(5):1112-8, 2016
                                      8. Gilcrease MZ et al: Transection of Radioactive Seeds in Breast Specimens. Am J Surg Pathol. 40(10):1375-1379, 2016
                                      9. Barentsz MW et al: Radioactive seed localization for non-palpable breast cancer. Br J Surg. 100(5):582-8, 2013
                                      10. Alderliesten T et al: Radioactive seed localization of breast lesions: an adequate localization method without seed migration. Breast J. 17(6):594-601, 2011
                                      11. McGhan LJ et al: Radioactive seed localization for nonpalpable breast lesions: review of 1,000 consecutive procedures at a single institution. Ann Surg Oncol. 18(11):3096-101, 2011
                                      12. van Riet YE et al: Identification of residual breast tumour localization after neo-adjuvant chemotherapy using a radioactive 125 Iodine seed. Eur J Surg Oncol. 36(2):164-9, 2010
                                      13. Pavlicek W et al: Radiation safety with use of I-125 seeds for localization of nonpalpable breast lesions. Acad Radiol. 13(7):909-15, 2006
                                      14. Gray RJ et al: Radioactive seed localization of nonpalpable breast lesions is better than wire localization. Am J Surg. 188(4):377-80, 2004
                                      15. Cox CE et al: Radioactive seed localization breast biopsy and lumpectomy: can specimen radiographs be eliminated? Ann Surg Oncol. 10(9):1039-47, 2003
                                      16. Gray RJ et al: Randomized prospective evaluation of a novel technique for biopsy or lumpectomy of nonpalpable breast lesions: radioactive seed versus wire localization. Ann Surg Oncol. 8(9):711-5, 2001
                                      17. Dauway EL et al: Innovative diagnostics for breast cancer: new frontiers for the new millennium using radioactive seed localization. Surg Forum. 50:348–349, 1999
                                      Related Anatomy
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Preprocedure

                                          • Procedure

                                            • Post Procedure

                                              • Outcomes

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Radioactive seed localization (RSL)
                                                • Definitions

                                                  • Image-guided placement of I-125 seed into breast lesion prior to surgical excision guided by gamma probe
                                                  • 0.200 mCi I-125 assayed activity when manufactured
                                                  • 35.5 keV gamma; 27 keV and 31.4 keV x-ray emissions
                                                  • 59.4 day half-life; 0.25-mm lead reduces exposure > 99%
                                                  • Silver iodide-coated seed in titanium capsule, 4.5 x 0.8 mm
                                                  • Survey meter: Geiger-Müeller gamma emission detector
                                                  • Gamma probe: Handheld, for intraoperative use

                                                PREPROCEDURE

                                                • Indications

                                                  • Contraindications

                                                    • Preprocedure Imaging

                                                      • Getting Started

                                                        PROCEDURE

                                                        • Patient Position/Location

                                                          • Procedure Steps

                                                            • Findings and Reporting

                                                              • Alternative Procedures/Therapies

                                                                POST PROCEDURE

                                                                • Expected Outcome

                                                                  • Things to Do

                                                                    • Things to Avoid

                                                                      OUTCOMES

                                                                      • Problems

                                                                        • Complications

                                                                          Selected References

                                                                          1. Da Silva M et al: Bracketed radioactive seed localization vs bracketed wire-localization in breast surgery. Breast J. 24(2):161-66, 2018
                                                                          2. Stelle L et al: Radioactive seed localization versus wire localization for nonpalpable breast lesions: a two-year initial experience at a large community hospital. Ann Surg Oncol. 25(1):131-36, 2018
                                                                          3. Xu XJ et al: An updated meta-analysis of radioactive seed localization versus wire-guided localization in the treatment of nonpalpable breast lesions. Breast J. 24(4):673-75, 2018
                                                                          4. Hayes MK: Update on Preoperative Breast Localization. Radiol Clin North Am. 55(3):591-603, 2017
                                                                          5. Tran VT et al: Comparative Evaluation of Iodine-125 Radioactive Seed Localization and Wire Localization for Resection of Breast Lesions. Can Assoc Radiol J. 68(4):447-455, 2017
                                                                          6. Bloomquist EV et al: A Randomized Prospective Comparison of Patient-Assessed Satisfaction and Clinical Outcomes with Radioactive Seed Localization versus Wire Localization. Breast J. 22(2):151-7, 2016
                                                                          7. Dryden MJ et al: Imaging Factors That Influence Surgical Margins After Preoperative 125I Radioactive Seed Localization of Breast Lesions: Comparison With Wire Localization. AJR Am J Roentgenol. 206(5):1112-8, 2016
                                                                          8. Gilcrease MZ et al: Transection of Radioactive Seeds in Breast Specimens. Am J Surg Pathol. 40(10):1375-1379, 2016
                                                                          9. Barentsz MW et al: Radioactive seed localization for non-palpable breast cancer. Br J Surg. 100(5):582-8, 2013
                                                                          10. Alderliesten T et al: Radioactive seed localization of breast lesions: an adequate localization method without seed migration. Breast J. 17(6):594-601, 2011
                                                                          11. McGhan LJ et al: Radioactive seed localization for nonpalpable breast lesions: review of 1,000 consecutive procedures at a single institution. Ann Surg Oncol. 18(11):3096-101, 2011
                                                                          12. van Riet YE et al: Identification of residual breast tumour localization after neo-adjuvant chemotherapy using a radioactive 125 Iodine seed. Eur J Surg Oncol. 36(2):164-9, 2010
                                                                          13. Pavlicek W et al: Radiation safety with use of I-125 seeds for localization of nonpalpable breast lesions. Acad Radiol. 13(7):909-15, 2006
                                                                          14. Gray RJ et al: Radioactive seed localization of nonpalpable breast lesions is better than wire localization. Am J Surg. 188(4):377-80, 2004
                                                                          15. Cox CE et al: Radioactive seed localization breast biopsy and lumpectomy: can specimen radiographs be eliminated? Ann Surg Oncol. 10(9):1039-47, 2003
                                                                          16. Gray RJ et al: Randomized prospective evaluation of a novel technique for biopsy or lumpectomy of nonpalpable breast lesions: radioactive seed versus wire localization. Ann Surg Oncol. 8(9):711-5, 2001
                                                                          17. Dauway EL et al: Innovative diagnostics for breast cancer: new frontiers for the new millennium using radioactive seed localization. Surg Forum. 50:348–349, 1999