Radioactive seed localization for non-palpable breast cancer

Background Radioactive seed localization (RSL) is an alternative to wire localization for guiding surgical excision of non-palpable breast cancer. This review provides an overview of the available evidence on the accuracy of RSL in patients undergoing breast-conserving surgery. Methods PubMed, Embase and the Cochrane Library were searched systematically in January 2012 for studies that addressed localization of non-palpable breast cancer using an iodine-125-labelled seed. Studies were deemed eligible if they reported on the proportion of patients with tumour-positive margins after RSL, the proportion of patients needing re-excision after RSL, and procedural complications. Results Six studies reported data on RSL in 1611 patients with non-palpable breast lesions. Overall complete resection rates ranged from 73 to 96 center dot 7 per cent. Three studies included over 300 patients, and complete resection rates in these studies varied between 89 center dot 5 and 96 center dot 7 per cent. The risk of seed migration and failure of seed placement ranged from 0 to 0 center dot 6 per cent and 0 to 7 center dot 2 per cent respectively. Conclusion Available scientific evidence suggests that RSL is a safe and accurate technique for localization of non-palpable breast lesions.