Our experience with the localization of non-palpable breast lesions using the radioactive seed Advantage™ I-125.

Abstract

Introduction: Non-palpable breast lesions that are eligible for breast-conserving surgery require precise preoperative localization of the pathological site. Mammographic screening and modern diagnostic methods contribute to the increasingly early detection of these lesions.

Methods: We present our two-year practical experience with the marking of non-palpa-ble breast lesions using the Advantage™ I-125 radioactive seed. This method was applied to 116 patients, 34 of whom had undergone successful neoadjuvant systemic therapy. The first 13 patients were marked using both the Frank wire method and radioactive seed application. The aim of our study was to evaluate the advantages and disadvantages of this method for both the patients and the entire multidisciplinary team.

Results: All pathological lesions were successfully removed during the primary procedure. In four patients, we observed seed displacement; however, the pathological lesion and the seed were always identified within the surgical field. Among the total number of patients, 73 underwent surgery for ductal carcinoma, 20 for lobular carcinoma, 8 for carcinoma associated with microcalcifications, 2 for invasive papillary carcinoma, and 13 for ambiguous biopsy findings. The method enables precise targeting of non-palpa-ble lesions with minimal radiation exposure for both the patients and the surgical team. Additionally, the cosmetic outcomes of this method were assessed as clearly positive.

Conclusion: The Advantage™ I-125 radioactive seed localization proved to be a reliable method for detecting non-palpable breast lesions with minimal complications. Its main advantages lie in the overall comfort for patients and the ability to optimize incision placement from an aesthetic perspective. Our results confirm the high effectiveness of this method in breast-conserving surgery while achieving R0 resection.