Abstract PO3-17-03: Impalpable breast lesion localisation device satisfaction in UK surgeons and radiologists: results of the iBRA-NET national practice questionnaire

Abstract

Abstract Introduction A national practice questionnaire in 2020 collected quantitative data from UK breast surgeons on breast localisation device use and found wire to be the most frequently used localisation device for impalpable lesions (Somasundaram, et al., 2020). Wire localisation was found to be associated with significant logistical issues including displacement and delays in theatre scheduling. Localisation device practice has changed greatly in the three years since the last questionnaire (Dave, et al., 2022). This study aimed to assess the change in device use, impact on logistics and to qualitatively assess surgeon and radiologist experience across the range of localisation devices. Methods The questionnaire was designed with identical questions to the 2020 study to allow for direct comparison of change, this collected information on demographics, logistics and device use. A pilot study was conducted to ascertain domains that were important to clinicians in differentiating between the quality of localisation device experience. The qualitative questions asked respondents to assign a Likert scale score of 0-10 for satisfaction in each identified domain. Two national practice questionnaires were created used SurveyMonkey® and were distributed to UK breast surgeons and radiologists via direct email, social media and the Association of Breast Surgery newsletter. The means of the satisfaction responses were compared with the mean responses for wire as the standard using a two-sample t test using Microsoft Excel. Results The surveys were completed between August and December 2022. There were 157 completed questionnaires, with 76 responses being from surgeons and 81 from radiologists. There has been significant change in the use of localisation devices in the UK, from 83% wire, 5% radio-occult lesion localisation (ROLL), 2% radioiodine seed and 9% Magseed® in 2020 to 45% wire, 2% ROLL, 3% radioiodine seed, 30% Magseed®, 5% SAVI SCOUT, 12% Hologic LOCalizer® and 2% Sirius Pintuition® by 2022. In 2020 9% of patients had localisation performed prior to the day of surgery, by 2022 this had increased to 64% (p < 0.05). Changes in localisation techniques also allowed these patients to undergo surgery earlier on a list; 15% of units in 2020 could operate on a localisation patient prior to 9am, by 2022 this was 41%. The satisfaction scores for Magseed® were statistically significantly higher than for wire in six of eight domains for surgeons and seven of nine domains for radiologists (p < 0.05). Surgeons found SAVI SCOUT® and Hologic LOCalizer® to be preferable to wire in five and seven domains respectively (p < 0.05). Discussion The follow-up survey demonstrates a change in practice in the use of newer localisation devices. The outcomes of the change seem to be an ability to place devices in advance, earlier start times in theatre and higher clinician satisfaction. The qualitative data demonstrates that clinicians are able to differentiate between the attributes of localisation devices. Due to a small sample size in some of the newer devices we are unable to directly compare between the newer devices, however, Magseed® scored significantly higher than wires in seven of the nine domains. Table 1: Qualitative comparison of feedback on the performance of devices. This Table shows the means of the satisfaction scores for surgeons and radiologists in the eight and nine qualitative domains respectively. Localisation devices were compared to wire as the standard using a two-sample t test, statistically significantly different results (p < 0.05) are marked with an asterisk. Citation Format: Fiona Mavor, James Harvey. Impalpable breast lesion localisation device satisfaction in UK surgeons and radiologists: results of the iBRA-NET national practice questionnaire [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-17-03.