Eco-logistical comparison of non-radioactive seeds and the wire-guided localization for intraoperative detection of breast lesions

IF 3.5 2区 医学 Q2 ONCOLOGY Ejso Pub Date : 2024-10-22 DOI:10.1016/j.ejso.2024.108779
Stefan Lukac , Elena Leinert , Thorsten Kühn , Davut Dayan , Florian Ebner , Kerstin Pfister , Henning Schäffler , Kristina Veselinovic , Wolfang Janni , Michael Hiete , Visnja Fink
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Abstract

Background

The current standard for the preoperative marking of non-palpable breast lesions is wire guided localization (WGL) which is associated with logistical efforts and patient discomfort. Non-radioactive seeds (NRS) recently challenged the use of WGL; but do they provide a better alternative from a logistical and environmental perspective?

Methods

WGL standard was compared with NRS available in Germany: Magseed®, Pintuition®, SAVI SCOUT ® and LOCalizer™ on a logistical and carbon-footprinting basis. In the logistical analysis the number of patient contacts with the healthcare system for lesion localization/removal and the number of breast punctures were evaluated in two different clinical scenarios (primary surgery and secondary surgery after neoadjuvant treatment). The carbon footprints of WGL and NRS (with exception of LOCalizer) were assessed based on their material compositions and operating energy in a streamlined approach.

Results

Application of NRS reduces the number of contacts by 33.3 % (2 vs. 3) in primary, by 50 % (2 vs. 4) in secondary surgery, and the number of breast punctures by 33.3 % (2 vs.3). Annual Germany-wide material- and energy-based carbon footprints of NRS (1.6–3.2 tons CO2eq) are significantly lower in comparison to WGL (10.3 tons CO2eq). The implementation of NRS would lead to a CO2eq reduction by around 79 % compared to WGL.

Conclusions

The use of NRS for the localization of non palpable breast lesions is more favorable from the environmental and logistical perspective, when compared to WGL with possible benefits for patients, healthcare providers and the environment.
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在术中检测乳腺病变时,对非放射性种子和导线引导定位进行生态统计比较。
背景:目前术前标记不可触及的乳腺病变的标准是线引导定位(WGL),这与后勤工作和患者不适有关。最近,非放射性种子(NRS)的使用对 WGL 提出了挑战;但从后勤和环境角度来看,它们是否提供了更好的替代方法?将 WGL 标准与德国现有的 NRS 进行比较:Magseed®、Pintuition®、SAVI SCOUT ® 和 LOCalizer™ 在物流和碳足迹基础上进行了比较。在后勤分析中,对两种不同的临床情况(初次手术和新辅助治疗后的二次手术)进行了评估,评估了患者为病灶定位/切除而与医疗系统接触的次数以及乳腺穿刺的次数。根据 WGL 和 NRS(LOCalizer 除外)的材料成分和运行能耗,以简化的方法对其碳足迹进行了评估:结果:使用 NRS 后,初次手术的接触次数减少了 33.3%(2 次对 3 次),二次手术的接触次数减少了 50%(2 次对 4 次),乳房穿刺次数减少了 33.3%(2 次对 3 次)。与 WGL(10.3 吨 CO2eq)相比,NRS 在全德国范围内的年度材料和能源碳足迹(1.6-3.2 吨 CO2eq)明显降低。与 WGL 相比,实施 NRS 可减少约 79% 的二氧化碳当量:结论:与 WGL 相比,从环境和物流角度来看,使用 NRS 对非触诊性乳腺病变进行定位更为有利,可为患者、医疗服务提供者和环境带来益处。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Ejso
Ejso 医学-外科
CiteScore
6.40
自引率
2.60%
发文量
1148
审稿时长
41 days
期刊介绍: JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.
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Calendar of events Editorial Board Reply to: “Optimizing the clinical utilization of geriatric nutritional risk index in esophageal squamous cell carcinoma treated with neoadjuvant immunochemotherapy” Optimizing the clinical utilization of geriatric nutritional risk index in esophageal squamous cell carcinoma treated with neoadjuvant immunochemotherapy Letter to the editor: “Validation of a supplementary condition of eighth AJCC staging system for stage II hepatocellular carcinoma”
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