Radioactive seed localization for conservative surgery of nonpalpable breast cancer
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2022
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International Journal of Surgery Protocols
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Background: The radioactive seed localization (RSL) is used in impalpable breast
cancer conservative surgery to assist the surgeon in accurately locating and excising
the lesion site. This study aims to present recommendations about the RSL program
implementation in health institutions that perform breast cancer conservative surgery
with intraoperative localization.
Methods: An extensive literature review was performed. It comprehends: the
committee responsible for implementation of the program actions; description of the
necessary multidisciplinary team; the radiological safety committee role; the facility
licensing; professionals training; material and instrumentation associated with the
technique; and seed tracking system.
Results: 13 topics are presented. The Program Implementation Committee must
be formed by leaders from each department. The committee assumes responsibility
for evaluating the necessary processes and presenting the schedule for program
implementation. Since the procedure is classified as a nuclear medicine procedure it
requires licensing. The Professional Team Formation, Education, and Training is a
priority and simulation exercises are necessary. The Materials and Instrumentation
Associated with the Technique must be well-know by the team and they should
practice using radiation detectors. The seed must be always tracked, from moment they
are received to discard. An Inventory for Tracking Seeds is provided. The Radiological
Safety Aspects such as the ALARA principle are presented. A full description for
the Radiological Procedure for Placing the seeds, the surgical removal and the
Specimen Handling in Pathology focusing on how to locate the seed and retrieve
them. After removed, the seeds can be placed in storage to wait for full radioactive
decay or be returned to the manufacturer.
Conclusions: The procedure has the advantage to increase to 2 months the time
between insertion of the seed and the surgical removal. Regular multidisciplinary team
meetings during program development are important to create a realistic timeline,
having briefing meetings after the first 1-5 RSL cases and having annual or biannual
follow-up meetings to discuss any issues or incidents.
Como referenciar
FERREIRA, HORTENCIA de J.; SOUZA, CARLA D. de; ROSTELATO, MARIA E.C.M. Radioactive seed localization for conservative surgery of nonpalpable breast cancer: recommendations for technology implantation program. International Journal of Surgery Protocols, v. 26, n. 1, p. 94-106, 2022. DOI: 10.29337/ijsp.182. Disponível em: http://repositorio.ipen.br/handle/123456789/34081. Acesso em: 12 May 2024.
Esta referência é gerada automaticamente de acordo com as normas do estilo IPEN/SP (ABNT NBR 6023) e recomenda-se uma verificação final e ajustes caso necessário.