A cutting-edge procedure called seed localization is improving patient satisfaction at The Dubin Breast Center of the Tisch Cancer Institute at The Mount Sinai Medical Center. In patients undergoing lumpectomy for cancers that are small and cannot be felt in the breast, a tiny radioactive seed is guided into the breast and implanted at the site of the tumor. The seed allows surgeons to better target and remove small breast tumors. This procedure is only available at a few centers in the country since its implementation involves significant coordination between a specialized team of breast surgeons and OR personnel, radiologists, nuclear medicine physicians and pathologists.
Prior to the development and implementation of seed localization, targeting small tumors could only be done with a procedure called needle localization. In this presurgical procedure a wire is guided to the site of the tumor using advanced imaging technology. Because the wire protrudes from the skin, this procedure was always performed on the day of surgery and remained in place until removed at surgery.
"Thankfully, with mammography and our advanced imaging techniques we are picking up tumors that are smaller and earlier than ever before," said Elisa Port, MD, Chief of Breast Surgery and Co-Director of the Dubin Breast Center. "Seed localization is another, more patient-friendly tool to specifically target the cancer and minimize the amount of time a patient spends in the hospital and in preparation on the day of surgery."
With seed localization, the seed is implanted in the days leading up to surgery, so that the patient does not have to arrive at the hospital hours before surgery, as they do with needle localization. Using local anesthesia in an exam room, the seed is guided into position using a pre-loaded needle and then implanted at the site of the tumor by a specialized breast radiologist. Patients do not have to fast prior to the placement of the seed, and the procedure is performed with minimal discomfort.
When the patient returns days later to have the tumor removed at surgery, she does not need to undergo the needle localization process, and instead goes straight to surgery. The surgical team uses a specialized handheld probe that detects the radioactive signal given off by the seed, allowing the surgeon to zero in and remove the target along with the adjacent tumor. No radioactivity remains within the breast once the tumor and seed are removed.
"With 3D mammography and now with seed localization, the Dubin Breast Center is continuously working to ensure our patients have access to the best, most advanced technology in breast cancer detection and treatment," said Laurie Margolies, MD, Associate Professor of Radiology and Chief of Breast Imaging at The Mount Sinai Medical Center. "Seed localization allows our surgeons to precisely remove cancerous tissue, reduces the volume of tissue required for removal, and greatly improves our patients' experience."
The Mount Sinai Medical Center