Key clinical point: In patients with early breast cancer (BC) who were undergoing breast-conserving surgery and sentinel lymph node detection (SLND), a combination of paramagnetic seed + superparamagnetic iron oxide (SPIO) led to comparable rates of re-excision and resection ratios as the more standard approach with guidewire + SPIO.
Major finding: Paramagnetic seed + SPIO and guidewire + SPIO showed comparable re-excision rates (2.87% vs 2.84%; P = .99) and median resection ratios (2.01 vs 1.93; P = .70). The rate of failed breast lesion localizations was significantly more in the guidewire vs paramagnetic seed group (10.1% vs 1.9%; P < .001).
Study details: Findings are from the phase 3 MAGTOTAL trial that included 426 patients with early BC scheduled to undergo breast-conserving surgery and SLND who were randomly assigned to either lesion localization using paramagnetic seed + SPIO or guidewire + SPIO.
Disclosures: This study was supported partly by Uppsala University Hospital. Sweden, and institutional grants from Uppsala University and other sources. A Karakatsanis declared receiving grants and honoraria from various sources outside the study.
Source: Pantiora E et al. Magnetic seed vs guidewire breast cancer localization with magnetic lymph node detection: A randomized clinical trial. JAMA Surg. 2023 (Dec 27). doi: 10.1001/jamasurg.2023.6520