Impalpable breast lesion localisation, a logistical challenge: results of the UK iBRA-NET national practice questionnaire.
INTRODUCTION
Breast conserving surgery of impalpable breast lesions requires safe and effective localisation techniques. Wire localisation has traditionally been used, but has limitations. Newer techniques are now being introduced to mitigate this. The iBRA-NET group aims to robustly evaluate these new techniques in well-designed prospective studies. We report the first phase of this evaluation, a survey to establish current practice and service provision of breast localisation techniques in the UK.


METHODS
A national practice questionnaire was designed using 'SurveyMonkey®' and was circulated to UK breast surgeons via the Association of Breast Surgery and the Mammary Fold. The questionnaire was live from 6th October 2018 to 6th April 2019. Only one response per unit was requested to reflect the unit's practice.


RESULTS
Complete responses were received from 98 breast units across the UK. Wires were the mostly commonly used localisation technique (n = 82) with fewer units using Magseed® (n = 9), Radioguided Occult Lesion Localisation (n = 5) and Radioiodine Seed Localisation (n = 2). There was significant variation in practice and logistics involved. Frequent delays and theatre overruns were reported in 39 and 16 units, respectively. The median satisfaction score of the current technique was 7 out of 10. The main perceived limitation of existing localisation methods was logistics affecting theatre scheduling and the main barrier to introducing a new technique was cost.


CONCLUSION
Wires are currently the most commonly used localisation technique but are associated with significant logistical issues. Newer techniques may offer a better solution but will need robust evaluation before they are adopted to ensure safety and efficacy.
['Somasundaram|Santosh K|SK|http://orcid.org/0000-0003-0776-4786', 'Potter|Shelley|S|', 'Elgammal|Suzanne|S|', 'Maxwell|Anthony J|AJ|', 'Sami|Amtul S|AS|', 'Down|Sue K|SK|', 'Dave|Rajiv V|RV|', 'Harvey|James|J|']
D001943:Breast Neoplasms D005260:Female D006801:Humans D007457:Iodine Radioisotopes D011446:Prospective Studies D011795:Surveys and Questionnaires D006113:United Kingdom
iBRA-NET Questionnaire Wire localisation Breast localisation Magseed