Clinical outcomes of magnetic seed and wire-guided localisation for non-palpable breast lesions: a systematic review and meta-analysis.

BACKGROUND

Wire-guided localisation (WGL) has been historically widely used as the standard method of pre-operative localisation of non-palpable breast lesions. Magnetic seeds (Magseed) were developed to overcome the logistical and technical limitations associated with wires. The aim of this systematic review was to compare the clinical outcomes associated with Magseed and WGL techniques.

METHODS

A systematic literature search of relevant databases was performed. A meta-analysis using the Mantel-Haenszel method was performed to calculate odds ratios (OR) for dichotomous outcomes and standardised mean differences (SMD) or mean differences (MD) for continuous outcomes, with 95% confidence intervals (CI).

RESULTS

16 studies involving 8794 (Magseed, n = 3995; WGL, n = 4799) patients were included. The rate of positive or close margins trended towards a lower rate for those who had Magseed localisation (OR 0.86, 95% CI 0.66-1.11; p = 0.23). Magseed localisation was associated with significantly lower re-excision rates (OR 0.77 95% CI 0.60-0.98; p = 0.03) compared to WGL. No significant differences were seen in terms of conversion to mastectomy, perioperative complications, localisation failures or operative time. Smaller resection size was observed with Magseed localisation (SMD -0.53 95% CI -0.98-0.08; p = 0.02).

CONCLUSION

Magseed localisation is a safe and effective alternative to WGL and is associated with reduced re-excision rates for positive margins. These findings support its use in breast conserving surgery, while awaiting further prospective data.