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Ann Surg Oncol. 2010 Dec;17(12):3241-6. doi: 10.1245/s10434-010-1139-4. Epub 2010 Jun 10.

Experience with seed localization for nonpalpable breast lesions in a public health care system.

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  • 1Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.



Seed localization uses a radioactive source to identify nonpalpable breast lesions for excision; it is an emerging alternative to wire localization (WL). Previous single health system studies report decreased rates of re-excision and improved patient convenience with this technique. This study is the first to implement this procedure in a public health care delivery system composed of a primarily minority and low-income population.


A multidisciplinary team was formed to create a protocol for breast seed localization (BSL) and monitor the results. After 50 seed localizations were successfully completed, a retrospective matched-pair analysis with patients who had undergone WL during the same period was performed.


Overall experience with the BSL protocol is reviewed, along with the occurrence of a seed loss. Processes necessary to reactivate the BSL protocol and prevent future losses are delineated. BSL is associated with decreased rates of re-excision and can be successfully implemented in a public health care system.


BSL is an attractive alternative to WL in a high-volume, county-based population. It allows increased efficiency in the operating room and has a low rate of complications. Cautionary measures must be taken to ensure proper seed chain of custody to prevent seed loss.

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