[Histonet] RE: breast tissue and radioactive seeds

[Gibson, Philip]

Hi Kaye

We've recently started using this procedure, so a (very) brief synopsis as follows:

Rather than a wire localisation of a breast tumour (using ultrasound) where a surgeon follows the wire to excise the tumour, a tiny radioactive seed is used instead. The seed is injected by syringe into the tumour, where it is "held" by the tissue (rather than a wire which can become dislodged by movement of the patient).
The surgeon then uses a fine-tuned radiation meter to locate the seed (and thus the tumour) for excision.

>From theatre, the breast excision specimen is x-rayed by our Radiology Dept to confirm that tumour does not appear to be at the resection margins (if it does, then a re-excision is done). Critically, because the seeds can be placed totally within the tumour, very few immediate shave re-excisions are required - this is the great advantage.

The histology lab receives the specimen, where we need to be very careful not to fracture/cut the seed. We use our own x-ray cabinet to show whereabouts in the specimen the seed is lying. Once the specimen is sliced, the seed is retrieved and the specimen trimmed as normal.

Here in the UK, the main concern over this technique is that no source of radiation can be lost (down a trimming bench sink, onto the floor etc.). We therefore have a complex chain of custody record which confirms the presence of the seed by radiation monitor at all areas of the hospital.

Hope this helps!

Phil






Date: Wed, 14 Jan 2015 15:39:50 +0000
From: <Robin.Ryan <@t> hcahealthcare.com<mailto:Robin.Ryan <@t> hcahealthcare.com>>
Subject: [Histonet] breast tissue and radioactive seeds
To: <histonet <@t> lists.utsouthwestern.edu<mailto:histonet <@t> lists.utsouthwestern.edu>>
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Hi Everyone,
After 5 years of being in the private sector I am now back in the wonderful environment of a hospital setting as the Histology supervisor.  We are going to be starting a new procedure here called "Conversion to Radioactive Seed Localized Breast Surgery" and I have been asked to come to this meeting.  As I have been strictly in Dermatology for the past few years I am not familiar with this process.  I have dealt with the prostate radioactive seeds before but not sure if this will involve the Histology lab in the form of surgical tissue or not.  I would like to be as informed as possible before the meeting which is next week, so I came to the source I value the most.  Can anyone share any information with me?

Thanks so much,
Kaye





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