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Impalpable breast lesion localisation, a logistical challenge: results of the UK iBRA-NET national practice questionnaire

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Abstract

Introduction

Breast conserving surgery of impalpable breast lesions requires safe and effective localisation techniques. Wire localisation has traditionally been used, but has limitations. Newer techniques are now being introduced to mitigate this. The iBRA-NET group aims to robustly evaluate these new techniques in well-designed prospective studies. We report the first phase of this evaluation, a survey to establish current practice and service provision of breast localisation techniques in the UK.

Methods

A national practice questionnaire was designed using ‘SurveyMonkey®’ and was circulated to UK breast surgeons via the Association of Breast Surgery and the Mammary Fold. The questionnaire was live from 6th October 2018 to 6th April 2019. Only one response per unit was requested to reflect the unit’s practice.

Results

Complete responses were received from 98 breast units across the UK. Wires were the mostly commonly used localisation technique (n = 82) with fewer units using Magseed® (n = 9), Radioguided Occult Lesion Localisation (n = 5) and Radioiodine Seed Localisation (n = 2). There was significant variation in practice and logistics involved. Frequent delays and theatre overruns were reported in 39 and 16 units, respectively. The median satisfaction score of the current technique was 7 out of 10. The main perceived limitation of existing localisation methods was logistics affecting theatre scheduling and the main barrier to introducing a new technique was cost.

Conclusion

Wires are currently the most commonly used localisation technique but are associated with significant logistical issues. Newer techniques may offer a better solution but will need robust evaluation before they are adopted to ensure safety and efficacy.

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Acknowledgements

Prof. Chris Holcombe, Royal Liverpool University Hospital, for contributions to the design of the national practice questionnaire

Funding

Association of Breast Surgery grant awarded to Mr. James Harvey to conduct this study.

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Authors and Affiliations

  1. Breast Screening Unit, Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS Foundation Trust, Ashton Road, Lancaster, LA1 4RP, UK

    Santosh K. Somasundaram

  2. Bristol Centre for Surgical Research, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Clifton, Bristol, BS8 2PS, UK

    Shelley Potter

  3. Bristol Breast Care Centre, Southmead Hospital, North Bristol NHS Trust, Southmead Road, Bristol, BS10 5NB, UK

    Shelley Potter

  4. University Hospital Crosshouse, Kilmarnock Rd, Crosshouse, Kilmarnock, KA2 0BE, UK

    Suzanne Elgammal

  5. The Nightingale Centre, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Southmoor Road, Manchester, M23 9LT, UK

    Anthony J. Maxwell, Rajiv V. Dave & James Harvey

  6. Division of Informatics, Imaging & Data Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PT, UK

    Anthony J. Maxwell

  7. Lincoln County Hospital, Greetwell Rd, Lincoln, LN2 5QY, UK

    Amtul S. Sami

  8. James Paget University Hospital, Lowestoft Road, Gorleston, Great Yarmouth, Norfolk, NR31 6LA, UK

    Sue K. Down

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  1. Santosh K. Somasundaram
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  8. James Harvey
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Correspondence to Santosh K. Somasundaram.

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Somasundaram, S.K., Potter, S., Elgammal, S. et al. Impalpable breast lesion localisation, a logistical challenge: results of the UK iBRA-NET national practice questionnaire. Breast Cancer Res Treat 185, 13–20 (2021). https://doi.org/10.1007/s10549-020-05918-6

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  • DOI: https://doi.org/10.1007/s10549-020-05918-6

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