This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Magnetic sentinel node and occult lesion localization in breast cancer (MagSNOLL Trial). BJS 2015; 102: 646-652.

Published: 13th April 2015

Authors: M. Ahmed, B. Anninga, S. Goyal, P. Young, Q. A. Pankhurst, M. Douek et al.

Background

Non‐palpable breast cancers require localization‐guided surgery and axillary staging using sentinel lymph node biopsy (SLNB). This study investigated the novel technique of magnetic‐guided lesion localization and concurrent SLNB, which avoids the need for wire‐guided localization and radioisotopes.

Method

An ultrasound‐guided intratumoral injection of magnetic tracer (0·5 ml) was performed in a protocol‐driven predefined minimum of ten patients with palpable breast cancer to assess the ability of the magnetic tracer safely to localize the tumour at the site of injection and concurrently drain to the lymphatics. Once successful lesion localization had been confirmed (peak magnetometer count retained at the centre of the tumour), the technique was undertaken in a further 20 patients with non‐palpable breast cancers awaiting wide local excision and SLNB. All patients underwent SLNB with both the magnetic and standard dual (radioisotope and Patent Blue V dye) techniques.

Results

Thirty‐two patients were recruited, of whom 12 (1 with bilateral disease) presented with palpable and 20 with non‐palpable breast cancer. Peak magnetometer counts were retained at the tumour centre in all palpable (13) and non‐palpable (20) breast cancers. Re‐excisions for involved margins were necessary in two patients with non‐palpable breast cancers. The sentinel lymph node identification rates were 28 of 33 procedures for the magnetic technique alone, 32 of 33 for the magnetic technique combined with blue dye, and 32 of 33 for the standard dual technique.

Conclusion

Magnetic lesion localization is feasible, with intratumoral magnetic tracer injection combined with a periareolar injection of blue dye for subsequent SNLB.

Full text

You may also be interested in

Original article

Population‐based study of the effect of preoperative breast MRI on the surgical management of ductal carcinoma in situ. BJS 2019; 106: 1488-1494.

Authors: K. B. I. M. Keymeulen, S. M. E. Geurts, M. B. I. Lobbes, E. M. Heuts, L. E. M. Duijm, L. F. S. Kooreman et al.

Original article

Nationwide population‐based study of the impact of immediate breast reconstruction after mastectomy on the timing of adjuvant chemotherapy.

Authors: E. Heeg, J. X. Harmeling, B. E. Becherer, P. J. Marang‐van de Mheen, M. T. F. D. Vrancken Peeters, M. A. M. Mureau et al.

Original article

International multidisciplinary expert panel consensus on breast reconstruction and radiotherapy. BJS 2019; 106: 1327-1340.

Authors: M. B. Nava, J. R. Benson, W. Audretsch, P. Blondeel, G. Catanuto, M. W. Clemens et al.

Original article

Prognostic impact of repeat sentinel lymph node biopsy in patients with ipsilateral breast tumour recurrence. BJS 2019; 106: 574-585.

Authors: I. G. M. Poodt, G. Vugts, R. J. Schipper, R. M. H. Roumen, H. J. T. Rutten, A. J. G. Maaskant‐Braat et al.

Notes: No impact

Original article

Effect of preoperative injection of superparamagnetic iron oxide particles on rates of sentinel lymph node dissection in women undergoing surgery for ductal carcinoma in situ (SentiNot study). BJS 2019; 106: 720-728.

Authors: A. Karakatsanis, A.‐F. Hersi, L. Pistiolis, R. Olofsson Bagge, P. M. Lykoudis, S. Eriksson et al.

Original article

Short‐term cost‐effectiveness of one‐stage implant‐based breast reconstruction with an acellular dermal matrix versus two‐stage expander‐implant reconstruction from a multicentre randomized clinical trial. BJS 2019; 106: 586-595.

Authors: V. L. Negenborn, J. M. Smit, R. E. G. Dikmans, H. A. H. Winters, J. W. R. Twisk, P. Q. Ruhé et al.

Original article

Autologous fat transplantation alters gene expression patterns related to inflammation and hypoxia in the irradiated human breast. BJS 2019; 106: 563-573.

Authors: A. Lindegren, I. Schultz, I. Sinha, L. Cheung, A. A. Khan, M. Tekle et al.

Notes: Effects on fibrosis after radiotherapy

Original article

Sentinel lymph node biopsy in microinvasive ductal carcinoma in situ. BJS 2019; 106: 375-383.

Authors: F. Magnoni, G. Massari, G. Santomauro, V. Bagnardi, E. Pagan, G. Peruzzotti et al.

Original article

Patient‐level costs in margin re‐excision for breast‐conserving surgery. BJS 2019; 106: 384-394.

Authors: Y. Grant, R. Al‐Khudairi, E. St John, M. Barschkett, D. Cunningham, R. Al‐Mufti et al.

Notes: Reoperations expensive

Systematic review

Meta‐analysis of sentinel lymph node biopsy after neoadjuvant chemotherapy in patients with initial biopsy‐proven node‐positive breast cancer. BJS 2018; 105: 1541-1552.

Authors: S. R. Tee, L. A. Devane, D. Evoy, J. Rothwell, J. Geraghty, R. S. Prichard et al.

Notes: In selected patients using dual tracer

Original article

Feasibility study of combined dynamic imaging and lymphaticovenous anastomosis surgery for breast cancer‐related lymphoedema. BJS 2019; 106: 100-110.

Authors: A. A. Khan, I. Hernan, J. A. Adamthwaite, K. W. D. Ramsey

Notes: Effective in selected patients

Randomized clinical trial

INTEND II randomized clinical trial of intraoperative duct endoscopy in pathological nipple discharge. BJS 2018; 105: 1583-1590.

Authors: G. Gui, A. Agusti, D. Twelves, S. Tang, M. Kabir, C. Montgomery et al.

Notes: Identifies causative lesion