It’s known as radioactive seed localization (RSL), and involves placing a tracker—a small and safe radioactive seed the size of a mustard seed—inside the breast tissue using ultrasound or mammography tools. In surgery, a gamma probe – a tool that senses radioactive material – is then used to scan over the patient’s breast and find the exact spot of the abnormal tissue. We can then take out the bad tissue and the seed and send the patient home the same day.
The seed helps us find spots that can’t be seen or felt. It may be cancer, a cluster of calcium or a benign lump, but the seed allows us to pinpoint it exactly and save more healthy tissue because of its accuracy. RSL has become a widely accepted treatment option for biopsies and lumpectomies, and is another option to needle (wire) localization.
With the wire, a needle is inserted into the patient’s breast and a small wire threaded through it. The tip of the needle is placed near the bad tissue, and the wire extends outside of the breast. Sometimes the space from the needle to the surface of the skin is pretty big. We follow the wire to the general area, make a best guess, and remove the tissue. Because it’s not exact, the wire option often removes extra tissue. Other disadvantages are that the wire must be placed right before surgery, it can move, and it is often uncomfortable for the patient.
In comparison, RSL provides several advantages to the patient, including
- Increased Accuracy
It is less likely that extra tissue will be taken out with RSL because the seed clearly marks the trouble spot. The tracker finds the location and allows us to get to the area from any angle, based on what will be the easiest and cosmetically best, and provides direction throughout the procedure. Since we must open up the tissue during surgery to remove the seed, we can look at the tissue on site and know whether or not all of the abnormal tissue has been removed. If not, we can go back and take a little more tissue, saving extra surgery, cost, worry, risk of infection and the look of the breast.
The amount of radiation in the seed is very small, making it safe for the patient and members of the healthcare team. The seed can be placed up to two days before surgery. But most are done right before surgery. Placing the seed in the patient’s breast takes less than 15 minutes and is done by a radiologist, and the surgery to remove the tissue takes about 30 minutes. Both are outpatient procedures and patients can return to regular activity the next day.
- Similar Cost
There is no additional cost to RSL, compared to the wire, and it produces better results.