Adoption of nonwire localisation devices in UK breast units: an iBRA-NET survey to assess changes in practice.

Abstract

Introduction: A national practice questionnaire in 2020 collected data from UK breast surgeons on breast localisation device use, and found that wires were used most frequently. The current study aimed to assess the change in device use since the previous questionnaire, impact on logistics and clinician feedback.

Methods: The 2020 national questionnaire was repeated, as well as adding qualitative questions to elicit themes important to clinicians in differentiating between the quality of localisation device experience. The electronic survey was distributed to UK breast surgeons and radiology members of the Association of Breast Surgery and British Society of Breast Radiology. The medians of the satisfaction responses for each device were compared with the median responses for wire.

Results: There were 157 completed questionnaires, with 76 responses from surgeons and 81 from radiologists/radiographers, representing 84 UK breast units (August-December 2022). Localisation device use has changed; from 83% wire and 17% nonwire (5% radio-occult lesion localisation, 2% radioiodine seed and 9% Magseed) in 2020 to 18% wire and 82% nonwire (4% radioiodine seed, 49% Magseed, 6% SAVI SCOUT, 20% Hologic LOCalizer and 3% Sirius Pintuition) by 2022. In 2020 6% of patients had localisation performed before the day of surgery versus 65% by 2022 (p<0.05). Nonwire devices were preferred to wire in six themes for surgeons (p<0.05) and four for radiologists (p<0.05).

Conclusions: UK breast surgery practice is shifting from use of guidewires towards newer localisation devices, with resultant logistical benefits and higher clinician satisfaction.