Radioactive Seeds Research Articles

Wired for Surgical Success: Our Experience with Preoperative Ultrasound-Guided Wire Localization of Impalpable Breast Lesions.

Aims The purpose of this study was to review our experience with preoperative ultrasound-guided wire localization and to identify our rate of successful localization and subsequent excision. Materials and Methods At our institution, we performed preoperative wire localization for 28 impalpable breast lesions in 27 women (1 patient underwent wire localization for bilateral breast lesions), between April 2016 and August 2019. We used a Toshiba APLIO2 ultrasound machine and a linear probe (7–12 MHz) to visualize lesions and needle-wire systems comprising a 20-gauge needle with preloaded wire to localize lesions. We analyzed the percentage of specimen mammograms with wire in situ and percentage of excised specimens showing margins free of tumor, along with imaging features, BI-RADS (Breast Imaging-Reporting and Data System) categories, and histopathological and molecular diagnosis of the lesions. Results All specimen mammograms confirmed the presence of wire in situ, except one (96.4%); in the latter case, postponement of surgery due to intractable cough was suspected to have caused wire displacement. All malignant specimens showed margins free of tumor (100%). Conclusions Our results show that wire localization is extremely effective in providing crucial preoperative insight into the precise location of an impalpable lesion. Despite the advent of nonwire localization devices such as radioactive seeds, radar reflectors, magnetic seed markers, and radiofrequency identification tags, wire localization remains the most widely practiced method, especially in resource-limited settings. Its high degree of accuracy serves as a key factor in the successful outcome of breast conservation surgery for impalpable breast lesions.

A machine-learning approach based on 409 treatments to predict optimal number of iodine-125 seeds in low-dose-rate prostate brachytherapy.

PurposeLow-dose-rate brachytherapy is a key treatment for low-risk or favorable intermediate-risk prostate cancer. The number of radioactive seeds inserted during the procedure depends on prostate volume, and is not easy to predict without pre-planning. Consequently, a large number of unused seeds may be left after treatment. The objective of the present study was to predict the exact number of seeds for future patients using machine learning and a database of 409 treatments.Material and methodsDatabase consisted of 18 dosimetric and efficiency parameters for each of 409 cases. Nine predictive algorithms based on machine-learning were compared in this database, which was divided into training group (80%) and test group (20%). Ten-fold cross-validation was applied to obtain robust statistics. The best algorithm was then used to build an abacus able to predict number of implanted seeds from expected prostate volume only. As an evaluation, the abacus was also applied on an independent series of 38 consecutive patients.ResultsThe best coefficients of determination R2 were given by support vector regression, with values attaining 0.928, 0.948, and 0.968 for training set, test set, and whole set, respectively. In terms of predicted seeds in test group, mean square error, median absolute error, mean absolute error, and maximum error were 2.55, 0.92, 1.21, and 7.29, respectively. The use of obtained abacus in 38 additional patients resulted in saving of 493 seeds (393 vs. 886 remaining seeds).ConclusionsMachine-learning-based abacus proposed in this study aims at estimating the necessary number of seeds for future patients according to past experience. This new abacus, based on 409 treatments and successfully tested in 38 new patients, is a good alternative to non-specific recommendations.

前列腺癌放射性粒子植入后并发溃疡性结肠炎1例并文献复习

前列腺癌放射性粒子植入后并发溃疡性结肠炎1例并文献复习

Effectiveness and Safety of Magseed-localization for Excision of Breast Lesions: A Prospective, Phase IV Trial.

A prospective, phase IV study was conducted to assess the effectiveness of Magseed to localize breast lesions requiring surgical excision. Since FDA approval in 2016, Magseed has been increasingly used to localize non-palpable lesions due to advantages over wires or radioactive seeds. This is the first prospective, post marketing trial of Magseed. From 1/2017-2/2018, 107 women with lesions requiring localization were enrolled at a single institution. Primary endpoint was Magseed retrieval rate. Secondary endpoints were adverse events, accuracy of placement, surgery duration and positive margin rate. Clinicians were surveyed for ease of use using a Likert scale. Descriptive statistics and Fisher's exact test were performed to assess univariable associations with positive margins. There were 124 Magseeds placed including one marker in 93 subjects, 2 markers in 11 and 3 markers in 3. The majority of lesions were masses (63%) followed by calcifications (24%). All 124 Magseeds were placed within 10mm of the target lesion and surgically retrieved with median operative time of 15min (range 4-47). No device-related adverse events occurred. Of the 98 malignant lesions, 9 had positive margins and 7 of them underwent a second surgery for additional margins. On univariable analysis, age ≤ 50 (25.0% vs 6.4%, p=0.04), lesion histology (p = 0.03), and pathologic T-stage (p = 0.04) were significantly associated with positive margins. Clinicians rated the Magseed very or fairly easy to use in most cases. The Magseed system for localization of non-palpable lesions was effective and safe; all markers were successfully retrieved with margin-negative resections in 91%. This study supports use of Magseed for localization of breast lesions.

ASO Author Reflections: Which Preoperative Breast Localization Method is More Economical: Radioactive Seed or Wire-Guided Localization?

ASO Author Reflections: Which Preoperative Breast Localization Method is More Economical: Radioactive Seed or Wire-Guided Localization?

Radioactive seeds insertion with chemotherapy for advanced non-small-cell lung cancer: A meta-analysis.

Non-small-cell lung cancers (NSCLCs) are only eligible to undergo curative surgical resection in <20% of patients. In patients with inoperable NSCLC, computed tomography (CT)-guided radioactive seed insertion (RSI) is a common treatment practice. To assess the relative efficacy of chemotherapy alone versus chemotherapy in combination with CT-guided RSI in patients with advanced NSCLC. We searched the Pubmed, Embase, and Cochrane Library databases for relevant articles published as of July 2020. Complete and total response rates (CR and TR, respectively) served as the primary endpoints for this meta-analysis, with disease control (DC) rate, myelosuppression rate, progression-free survival (PFS), overall survival (OS), and CT-guided RSI-related pneumothorax serving as secondary endpoints. In total, eight studies incorporating 281 patients that underwent combination treatment and 297 patients that underwent chemotherapy along were included in this meta-analysis. The CR (21.5% vs. 4.0%, P<0.00001), TR (73.8% vs. 42.6%, P<0.00001), and DC (94.1% vs. 78.2%, P<0.00001) rates were significantly higher for patients in the combined treatment group relative to patients in the chemotherapy only group. Furthermore, pooled PFS (P<0.00001) and OS (P=0.0006) were significantly longer for patients in the combined treatment group, whereas no differences in pooled myelosuppression rates were observed between groups (34.3% vs. 30.7%, P=0.47). The pooled rate of CT-guided RSI-related pneumothorax was 15%. Combination chemotherapy and CT-guided RSI can significantly improve clinical response and prolong survival in advanced-stage NSCLC patients without inducing other significant toxic side effects.

306 Poster - A Breast 3D model as a possible tool for non-invasive tumour localization in breast surgery

Background: For tumour location and surgical planning physicians need to convert 2-D information into a 3D approach. Wire guided surgery is the most common method for preoperative localization of breast cancer lesions. Other localization methods can also be used, such as radioactive seeds, carbon tattooing or ultrasound guided clips, but they are all invasive procedures. In this work, we aimed at building an individualized 3D digital breast model integrating the breast torso and tumor location through MRI/3D fusion algorithms to help in pre-operative tumour location without the use of invasive procedures.

2 Oral - Tailored axillary treatment after neoadjuvant systemic therapy in clinically node-positive breast cancer patients is safe: 3-year follow-up of the MARI protocol

Background: More than one-third of clinically node positive (cN+) breast cancer (BC) patients currently show a pathologic complete response (pCR) of the axilla after neoadjuvant systemic therapy (NST). In patients with pCR, axillary lymph node dissection (ALND) is considered as overtreatment. The MARI procedure (Marking Axillary lymph nodes with Radioactive Iodine seeds) combined with pre-NST FDG-PET/CT (MARI protocol) is an accurate method to restage the axilla after NST. Here, we present 3-year follow-up results of BC patients treated according to the MARI protocol.

Comparison of Multiple Wire, Radioactive Seed, and Savi Scout® Radar Localizations for Management of Surgical Breast Disease

Radioactive seed localization (RSL) and the Savi Scout® radar (SSR) are newer alternatives to wire-guided localization (WL) for nonpalpable breast lesions. The aim of this study was to compare three localization devices when multiple devices were used for preoperative localization for breast surgery. Between July 2017 and July 2018, 68 patients had a partial mastectomy (n=54) or breast biopsy (n=14) with preoperative image-guided localization using multiple wires or device placement for nonpalpable lesions. Operative timing, outcomes, and 30-day complications were evaluated. Overall, 41 patients (60%) had WL, 11 patients (16%) had RSL, and 16 patients (24%) had SSR localization. Fifty-four patients (79.4%) had localization of two lesions and 13 patients (19.1%) had localization of three lesions. Twenty-three patients (33.8%) had a lesion that was bracketed. There was no difference in retained biopsy clip among the groups (average 7.4%; p=0.962). For operations performed in the hospital, there was no difference in operative time among the groups, with a median of 77.5 min (p=0.705) or total perioperative time of 508 min (p=0.210). Among operations with delayed start times, there was a longer average delay of 95.5 min in WL, compared with 42 min in SSR (p=0.004). A greater volume of tissue was excised in the WL group (29.5g WL vs. 15.9g RSL vs. 12.1g SSR; p=0.022). There was no difference in positive margin rate and 30-day complications among groups. SSR and RSL can be used to localize multiple breast lesions, with no difference in positive margin rates or complications and less tissue excised compared with WL.

Fully Balanced SSFP Without an Endorectal Coil for Postimplant QA of MRI-Assisted Radiosurgery (MARS) of Prostate Cancer: A Prospective Study

To investigate fully balanced steady-state free precession (bSSFP) with optimized acquisition protocols for magnetic resonance imaging (MRI)-based postimplant quality assessment of low-dose-rate (LDR) prostate brachytherapy without an endorectal coil (ERC). Seventeen patients at a major academic cancer center who underwent MRI-assisted radiosurgery (MARS) LDR prostate cancer brachytherapy were imaged with moderate, high, or very high spatial resolution fully bSSFP MRIs without using an ERC. Between 1 and 3 signal averages (NEX) were acquired with acceleration factors (R) between 1 and 2, with the goal of keeping scan times between 4 and 6 minutes. Acquisitions with R >1 were reconstructed with parallel imaging and compressed sensing (PICS) algorithms. Radioactive seeds were identified by 3 medical dosimetrists. Additionally, some of the MRI techniques were implemented and tested at a community hospital; 3 patients underwent MARS LDR prostate brachytherapy and were imaged without an ERC. Increasing the in-plane spatial resolution mitigated partial volume artifacts and improved overall seed and seed marker visualization at the expense of reduced signal-to-noise ratio (SNR). The reduced SNR as a result of imaging at higher spatial resolution and without an ERC was partially compensated for by the multi-NEX acquisitions enabled by PICS. Resultant image quality was superior to the current clinical standard. All 3 dosimetrists achieved near-perfect precision and recall for seed identification in the 17 patients. The 3 postimplant MRIs acquired at the community hospital were sufficient to identify 208 out of 211 seeds implanted without reference to computed tomography (CT). Acquiring postimplant prostate brachytherapy MRI without an ERC has several advantages including better patient tolerance, lower costs, higher clinical throughput, and widespread access to precision LDR prostate brachytherapy. This prospective study confirms that the use of an ERC can be circumvented with fully bSSFP and advanced MRI scan techniques in a major academic cancer center and community hospital, potentially enabling postimplant assessment of MARS LDR prostate brachytherapy without CT.

Budget Impact Analysis of Preoperative Radioactive Seed Localization.

This study models costs in implementing a radioactive seed localization (RSL) program for nonpalpable breast lesions at a large Canadian tertiary hospital to replace existing wire-guided localization (WGL). All direct and indirect operating costs of localization per lesion from the hospital's perspective were determinedby retrospectively reviewing patient data and costs from January 2014to December 2016. A budget impact analysis and sensitivity analysis were performed to calculate the mean cost per lesion, the minimum and maximum cost per lesion, operational costs, and initial costs. There were 265 WGL lesions in 2014 and 170 RSL lesions in 2016 included in cost calculation. The mean cost per localization was $185 CAD for WGL ($148-$311) and $283 CAD ($245-$517) for RSL using preloaded seeds, adjusted to 2016 Canadian dollars. The annual operational expenditure including all localizations and overhead costs was $49,835 for WGL and $80,803 for RSL. Initial costs for RSL were $22,000, including external training and new equipment purchases. Our budget impact analysis shows that RSL using preloaded radioactive seeds was more expensive than WGL when considering per-lesion localization costs and specific costs related to radiation safety. Manually loading radioactive seed could be a cost-saving alternative to purchasing preloaded seeds.Our breakdown of costs can provide a framework for other centres to determine which localization method best suit their departments.

A deep learning method for real-time intraoperative US image segmentation in prostate brachytherapy.

This paper addresses the detection of the clinical target volume (CTV) in transrectal ultrasound (TRUS) image-guided intraoperative for permanent prostate brachytherapy. Developing a robust and automatic method to detect the CTV on intraoperative TRUS images is clinically important to have faster and reproducible interventions that can benefit both the clinical workflow and patient health. We present a multi-task deep learning method for an automatic prostate CTV boundary detection in intraoperative TRUS images by leveraging both the low-level and high-level (prior shape) information. Our method includes a channel-wise feature calibration strategy for low-level feature extraction and learning-based prior knowledge modeling for prostate CTV shape reconstruction. It employs CTV shape reconstruction from automatically sampled boundary surface coordinates (pseudo-landmarks) to detect the low-contrast and noisy regions across the prostate boundary, while being less biased from shadowing, inherent speckles, and artifact signals from the needle and implanted radioactive seeds. The proposed method was evaluated on a clinical database of 145 patients who underwent permanent prostate brachytherapy under TRUS guidance. Our method achieved a mean accuracy of [Formula: see text] and a mean surface distance error of [Formula: see text]. Extensive ablation and comparison studies show that our method outperformed previous deep learning-based methods by more than 7% for the Dice similarity coefficient and 6.9 mm reduced 3D Hausdorff distance error. Our study demonstrates the potential of shape model-based deep learning methods for an efficient and accurate CTV segmentation in an ultrasound-guided intervention. Moreover, learning both low-level features and prior shape knowledge with channel-wise feature calibration can significantly improve the performance of deep learning methods in medical image segmentation.

Radiotherapy and Its Impact on the Nervous System of Cancer Survivors.

Radiotherapy is routinely used for the treatment of nearly all brain tumors, but it may lead to progressive and debilitating impairments of cognitive function. The growing evidence supports the fact that radiation exposure to CNS disrupts diverse cognitive functions including learning, memory, processing speed, attention and executive functions. The present review highlights the types of radiotherapy and the possible mechanisms of cognitive deficits and neurotoxicity following radiotherapy. The review summarizes the articles from Scopus, PubMed, and Web of science search engines. Radiation therapy uses high-powered x-rays, particles, or radioactive seeds to kill cancer cells, with minimal damage to healthy cells. While radiotherapy has yielded relative success in the treatment of cancer, patients are often plagued with unwanted and even debilitating side effects from the treatment, which can lead to dose reduction or even cessation of treatment. Little is known about the underlying mechanisms responsible for the development of these behavioral toxicities; however, neuroinflammation is widely considered as one of the major mechanisms responsible for radiotherapy-induced toxicities. The present study reviews the different types of radiotherapy available for the treatment of various types of cancers and their associated neurological complications. It also summarizes the doses of radiations used in the variety of radiotherapy, and their early and delayed side effects. Special emphasis is given to the effects of various types of radiations or late side effects on cognitive impairments.

Radioactive Seed Versus Wire-Guided Localization for Ductal Carcinoma in Situ of the Breast: Comparable Resection Margins

BackgroundThere are currently two widely used methods for preoperative localization of ductal carcinoma in situ (DCIS) of the breast: wire-guided localization (WGL) and radioactive seed localization (RSL). Several studies compared these localization techniques in small cohorts.ObjectiveThe aim of this study was to compare the surgical resection margin status between RSL and WGL in a large national cohort of patients with DCIS.Patients and MethodsWe included patients from the Dutch Pathology Registry who underwent breast-conserving surgery for DCIS by either RSL (n = 1851) or WGL (n = 2187) between 2009 and 2019. Several clinicopathological characteristics were compared between these two groups, including resection margin status and number of re-excisions.ResultsPatients undergoing RSL were younger (p = 0.014) and were more often diagnosed with a large DCIS (p = 0.013), high grade DCIS (p < 0.001) and comedonecrosis (p < 0.001) compared with patients undergoing WGL. There was no significant difference in resection margin status between both groups (p = 0.089) and the number of re-excisions (p = 0.429). However, in case of re-excision, patients in the RSL group were more often treated with breast-conserving surgery (p = 0.029).ConclusionIn this large national cohort study of patients with DCIS, we demonstrated that there was no difference in resection margin status between both procedures, or in the number of re-excisions, but patients in the RSL group were more often treated with breast-conserving therapy in case of a re-excision.

Abstract A10: Treatment of squamous cell carcinoma by alpha radiation-based brachytherapy (Alpha DaRT)

Abstract Objective: The first clinical trial in humans with skin and oral cavity squamous cell carcinoma (SCC) was performed in order to evaluate the effect of a unique intratumoral alpha radiation-based tumor ablation treatment termed Diffusing Alpha-emitters Radiation Therapy (DaRT). Methods: Radium-224 loaded sources (DaRT seeds) were inserted into solid tumors and released by recoil short-lived alpha-emitting atoms (Rn-220, Po-216, Pb-212, Bi-212, Po-212, Tl-208). These atoms disperse in the tumor and spray it with highly destructive alpha radiation. The decay products diffuse in the tumor mass to a distance of at least 5 mm. Results: A feasibility and safety clinical study is ongoing and currently 28 patients were treated at the Rabin Medical Center (Israel) and IRST (Italy). Patients with histopathologic confirmed skin or head and neck SCC, and tumor size ≤5 centimeters in the largest diameter, were enrolled. Treatment was delivered based on a CT-simulation pretreatment plan. The seeds (1 cm long and 0.7 mm in diameter), each carrying a dose of 2 μCi, were placed up to 5 millimeters from each other. CT was used in order to confirm the position of the radioactive seeds. Two weeks after implantation the seeds were removed, and six weeks after treatment a CT scan was performed to assess the effect of treatment. Study results are available for 18 cases that were treated per protocol and reached the 30-day follow-up period. Age of the patients ranged from 60 to 102 years (median 80 years). Ten patients had oral cavity SCC and 18 were diagnosed with cutaneous SCC. Thirteen subjects were treated within prior radiation failure fields (radiation dosage &amp;gt;60Gy). All tumors responded to the treatment; 13 tumors exhibited a complete response and five tumors showed partial response. No major toxicity was noted. Conclusions: In this first feasibility and safety human study we demonstrated that alpha-based treatment (DaRT) resulted in enhanced radiobiologic potential. Furthermore, the treatment was effective against radioresistant SCC tumors without any major side effects. Citation Format: Aviram Mizrachi, Aron Popovtzer, Eli Rosenfeld, Ran Ben-Hur, Itzhak Kelson, Yona Keisari. Treatment of squamous cell carcinoma by alpha radiation-based brachytherapy (Alpha DaRT) [abstract]. In: Proceedings of the AACR-AHNS Head and Neck Cancer Conference: Optimizing Survival and Quality of Life through Basic, Clinical, and Translational Research; 2019 Apr 29-30; Austin, TX. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(12_Suppl_2):Abstract nr A10.

Early budget impact analysis on magnetic seed localization for non-palpable breast cancer surgery.

IntroductionCurrent localization techniques used in breast conserving surgery for non-palpable tumors show several disadvantages. Magnetic Seed Localization (MSL) is an innovative localization technique aiming to overcome these disadvantages. This study evaluated the expected budget impact of adopting MSL compared to standard of care.MethodsStandard of care with Wire-Guided Localization (WGL) and Radioactive Seed Localization (RSL) use was compared with a future situation gradually adopting MSL next to RSL or WGL from a Dutch national perspective over 5 years (2017–2022). The intervention costs for WGL, RSL and MSL and the implementation costs for RSL and MSL were evaluated using activity-based costing in eight Dutch hospitals. Based on available list prices the price of the magnetic seed was ranged €100-€500.ResultsThe intervention costs for WGL, RSL and MSL were respectively: €2,617, €2,834 and €2,662 per patient and implementation costs were €2,974 and €26,826 for MSL and RSL respectively. For standard of care the budget impact increased from €14.7m to €16.9m. Inclusion of MSL with a seed price of €100 showed a budget impact of €16.7m. Above a price of €178 the budget impact increased for adoption of MSL, rising to €17.6m when priced at €500.ConclusionMSL could be a cost-efficient localization technique in resecting non-palpable tumors in the Netherlands. The online calculation model can inform adoption decisions internationally. When determining retail price of the magnetic seed, cost-effectiveness should be considered.

Preoperative Localization of Breast MRI Lesions: MRI-guided Marker Placement With Radioactive Seed Localization as an Alternative to MRI-guided Wire Localization.

Preoperative MRI-guided wire localization (MWL) presents challenges to both the physician and patient. In this study, we examined the efficiency and outcome of MRI-guided marker placement followed by mammographic-guided radioactive seed localization (MMP/RSL) as an alternative localization method. The primary outcome parameter was pathology upon excision. The secondary outcome parameters were total procedure time and clinical indication for localization. A retrospective review of a large tertiary cancer center's breast imaging database was performed. Records of 21 patients with MMP/RSL (24 markers) from August 2013 to January 2019 were compared with 34 patients receiving MWL (48 wires) from January 2016 to January 2019. Multiple factors, including age, prelocalization pathology, postsurgical pathology, concordance, re-excision rates, and total procedure time required for each technique, were compared. Univariate and descriptive statistical analyses were performed. Mean patient age in years (MMP/RSL = 54.1 ± 13.1, MWL = 55.1 ± 10.8, P = 0.389), time in MR scanner in minutes (MMP/RSL = 31.7 ± 12.0, MWL = 35.8 ± 13.1, P = 0.678), and postsurgical pathology malignancy rates (MMP/RSL = 71.4%, MWL = 65.7%, P = 0.7715) were similar without statistically significant differences. As expected, the mean total procedure time was slightly longer without a statistically significant difference (47.3 ± 19.8 min versus 35.8 ± 13.1 min, P = 0.922) for the MMP/RSL group. All patients in both groups underwent successful localization with 100% radiologic-pathology concordance. Re-excision rates were lower for the MMP/RSL group (9.5%) versus the MWL group (16.7%); however, they were not found to be statistically significant (P = 0.7104). MMP/RSL is a feasible alternative to MWL and may alleviate many challenges presented by MWL. Further studies are needed.

A Safe Way to Perform MRI-guided Radioactive Seed Localization.

A Safe Way to Perform MRI-guided Radioactive Seed Localization.

How to Safely Perform Magnetic Resonance Imaging-guided Radioactive Seed Localizations in the Breast.

When a breast lesion is seen on only magnetic resonance imaging (MRI) and needs to be excised, pre-operative MRI-guided radioactive seed localization (RSL) is preferred. However, MRI safety and radiation safety issues associated with the inability to recover a potentially lost seed in the MRI scanner room (Zone IV) have precluded this in the past. This manuscript provides a protocol for MRI-guided RSLs that meets MRI safety and radiation safety criteria established by the American College of Radiology and the Nuclear Regulatory Commission. To the authors’ best knowledge, this has never been published in the literature. The complete protocol is provided.

P14 The use of magnetic seed for breast lesion localisation in a regional hospital: A Case Series

Background and purpose Magnetic seeds are a new and exciting technology that is starting to be used for localisation of non-palpable breast lesions. They provide an easier pathway for the patient with insertion within four weeks of the operation and reduced risk of migration compared to wire-guided localisation (James R. Harvey, 2018). They also pose no radiation risk, and do not require a destruction protocol in comparison to radioactive seeds (Magseed, 2019). Despite magnetic seeds being proven as safe and feasible (James R. Harvey, 2018), there has been little research into their effectiveness in breast lesion localisation. Our study aimed to begin to investigate the effectiveness of magnetic seeds in breast lesion localisation. Methods Our case series was a retrospective review of twenty-five cases in one peripheral hospital to investigate the clear margin rate, tumour size to specimen weight ratio and to see if there were problems with seed migration or failure of localisation. Results We found overall 64% of cases had clear margins, with 36% requiring further surgery. The rate of surgery required for extra margins was reduced further to 17.6% after the first eight cases were excluded, suggesting a learning curve. Tumour size to specimen weight ratio was 3.07. There were no concerns with seed migration and only two cases of seed localisation failure. In the two cases where the seed localisation failed, simple measures could have mitigated against this. Conclusions This case study provides further evidence that magnetic seeds are a safe and viable alternative to radioactive seeds or wire guided localization. James R. Harvey, Y. L. (2018). Safety and feasibility of breast lesion localisation using magnetic seeds (Magseed): a multi-centre, open-label cohort study. Breast Cancer Research and Treatment, 531-536.Magseed. (2019, June 20). Endomagnetics Ltd. Retrieved from Endomag: www.endomag.com.