The 42-year-old woman arriving for her lumpectomy is nervous. The patient recently received a breast cancer diagnosis, but she feels well informed about her breast surgeon’s plan to remove the lesion. The patient arrives 15 minutes early for her 7 a.m. appointment to have a localization wire inserted; her surgeon plans to rely on the wire to locate the lesion, which measures 2 centimeters.
The wire is inserted in the mammography suite, and then it’s time to wait for her 9 a.m. surgery. But she feels cold and pulls on a sweater around 7:30 a.m.–and, in the process, she dislodges the wire. Little does she know it, but the fate of her surgical procedure now hangs in the balance.
Because now there’s a mad scramble to get her back to the mammography suite where the wire can be reinserted. It also creates a hole in the surgery schedule, which means her breast surgeon can anticipate a longer and more stressful day.
Wireless guidance empowers breast surgeons
One solution to this problem is to incorporate use of the LOCalizer™ Wire-free Guidance System as part of pre-surgical planning. Developed by Marlborough, Mass.-based Hologic, Inc, the LOCalizer is a wireless radio frequency identification (RFID) breast lesion system that will potentially enable precision and ease of use for breast surgery guidance.
The LOCalizer system includes:
- A miniature RFID tag with a unique ID number pre-loaded in a needle applicator
- A single-use surgical probe with a small, approximately 8 mm tip
- A portable handheld reader that can be used in a sterile (when enclosed in the system’s sterile drape) or unsterile environment
The RFID tag can be inserted days or hours before the surgical procedure, which means no last-minute changes to mammography or surgery schedules.
Reduce Stress and Difficulty of Localization
Wire locators and radioactive seeds can help breast surgeons locate cancerous lesions, but
each approach presents its own difficulties.
Wire localization presents challenges
Valerie Gorman, MD, Valerie Gorman, MD, FACS, a breast surgeon at Texas Breast Center in Waxahachie, described wire localization as safe, cost-effective, well established, and guided by mammogram, ultrasound, or MRI guidance, in an April 2020 presentation.
Still, she highlighted that the wire can get dislodged or migrate. Or it can fracture or be transected before or during surgery. Another potential challenge is the difficulty locating the end of the wire, explained Gorman. In addition, since the wire is inserted during compression, it may move, which can be a concern for women with pendulous breasts.
Any of those events can mean the patient needs to have the wire reinserted in the mammography suite, and that can mean delays. Operating room scheduling is “precious time to all of us,” said Gorman.
The surgery schedule can get thrown off if there’s a delay in the mammography suite. Gorman said that 10% to 20% of patients pass out while the wire is placed and patients can be concerned about potentially dislodging the placed wire.
Wireless localization benefits patients and clinicians
Often, a mammography scheduler will cluster together patients who are scheduled for a particular procedure. That could mean that Gorman’s patients who need to have a wire inserted have their appointments pushed to the afternoon–and that can cause disruption to the surgery schedule while creating a bad experience for the patient.
Gorman used to tell her patients who had to wait to have a wire inserted to “bring a good book because you’ll read half of it” while waiting in the mammography suite. The waiting and the fear of dislodging the wire while they wait for their surgery “adds to the anxiety of an already anxiety-filled moment in their life,” she said.
She’s been very happy with the LOCalizer system, and her patients have had an improved experience, as a result, said Gorman.
Hear from Dr. Fine on the Benefits of Ultrasound Localization
Dr. Richard E. Fine, Breast Surgeon and Director of Education and Research discusses his thoughts and experience using the LOCalizer™ Wire-free Guidance System.