The iBRA-NET National Audit of localisation techniques for breast lesions
A prospective audit of the outcomes of current techniques of breast localisation, which started with a prospective audit of Magseed® localisation of breast lesions compared to a control group of wire localised lesions (see Results section). The study is being facilitated through the Mammary Fold and the National Research Collaborative network. In January 2021 we are launching a prospective audit of Hologic LOCalizer™, which will be open to all users, either new users or established users.
Excision of impalpable breast lesions is usually directed by preoperative wire placement into or adjacent to the target lesion. Wire localization has several disadvantages, most notably, displacement of the wire, and difficulty in the surgeon discerning accurately the position of the tip of the wire intraoperatively. Magseed®, LOCalizer™ and Savi Scout® are alternative methods for localising impalpable breast cancers which may have advantages over wire localisation in many areas.
Between Feb 2019 and Sept 2020 as a group of breast surgeons we collected data on over 2000 procedures with wire localisation and Magseed®. These data are due for publication in early 2021 and will act as comparative groups for future studies of other localisation techniques. The aim is that all innovative devices introduced are evaluated as they are used and we can together as a network establish safety and efficacy data collaboratively.
Set up Key Performance Indicators to compare the outcomes of breast localisation devices (complete)
Describe the current practice of breast localisations (complete – see Results section).
Evaluate the outcomes of novel localisation techniques vs Wire localisation
To inform a future prospective trial in breast localisation surgery
To identify and disperse any learning points on new devices
Primary outcome – Identification rate of index lesion
Accuracy of placement
Pathological weight of specimen
Transcutaneous detection rate
Cancellation rate on day of surgery
Reason for cancellation on day of surgery
Time of day of start of surgery
Learning points from surgery
Sensitivity of devices for bracketing lesions.
National UK practice of breast localisations;
Somasundaram SK, Potter S, Elgammal S, Maxwell AJ, Sami AS, Down SK, Dave RV, Harvey J. Impalpable breast lesion localisation, a logistical challenge: results of the UK iBRA-NET national practice questionnaire. Breast Cancer Res Treat. 2020 Sep 10. doi: 10.1007/s10549-020-05918-6. Epub ahead of print. PMID: 32914355.
Early results of Magseed and wire localisation study (due for presentation to Ibranet in Jan 2021 and for subsequent publication Spring 2021)
35 participating units
2460 lesions localised
Lesion localisation rate – 99.8% Magseed® and 99.1% wire, equivalent complication rates and safety.
Summary: Magseed is highly accurate and comparable with wire localisation when used in normal practice in a multi-centre manner.
iBRA Study Steering and Protocol Management Group
James Harvey (Chair), Suzanne Elgammal - Secretary, Nicola Barnes, Chris Holcombe – Ibranet lead, Shelley Potter – ibranet lead, Santosh Somasundaran – Protocol design and questionnaire design, Rajiv Dave- Redcap Lead, Anthony Maxwell – Radiology Lead, Senthurun Mylvaganam – Lead for Shared Learning, Amtul Sami, AB Kasem, Tahir Masudi, Sue Down, Yazan Masannat, Rob Milligan, Julia Henderson, Jenna Morgan, Mihir Chandarana