The Dr. Negrín University Hospital of Gran Canaria, a center dependent on the Ministry of Health of the Government of the Canary Islands, through the General Surgery and Radiology services, members of the Breast Unit, incorporates the implantation of ferromagnetic seeds to locate nodes that are affected by a tumor. Thus, only those nodes can be selectively removed avoiding the removal of all the lymph nodes in the armpit. The use of this technique, which is performed after giving chemotherapy, allows to be more conservative and precise in the surgical treatment of breast cancer. What’s more, the objective is to use it, in the near future, for the localization and removal of breast tumors that are not palpable.
It is a novel technique which is beginning to be carried out in several Spanish hospitals. The University Hospital of Gran Canaria Dr. Negrín has already incorporated it, being the first canary hospital in doing it. At this time, as experts assure, there is evidence that shows that lymph nodes can be preserved after chemotherapy in certain patients who have responded to treatment, avoiding the dreaded complications of axillary lymphadenectomy and radiotherapy, one of them being and perhaps the best known, lymphedema (swelling of the upper limb). This complication can imply a significant functional limitation and risk of infection.
The Breast Unit of the hospital center has carried out the removal of the lymph nodes affected by the tumor since 2017. However, to locate these nodes it was necessary to place, before administering chemotherapy, a metal clip. After chemotherapy, and as a step prior to surgery, a metal guide (called a harpoon) was incorporated into the patient’s armpit in order to locate the nodes in the operating room. The harpoon is a kind of long wire whose tip is shaped like an umbrella and is anchored in the tissue, in this case, the ganglion. Traditionally it has been used to locate non-palpable tumors in the breast. Although the results obtained through this technique are good, it contains some difficulty and possible complications. In addition, it is uncomfortable for the patient.
For this reason, the use of ferromagnetic seeds represents an important advance for patients and an improvement in the quality of care. Ferromagnetic Seed (Magseed®-Sysmex) is a small piece of stainless steel about five millimeters long and one millimeter wide, which is introduced into the ganglion or breast tissue of the patient by means of needles that have it incorporated; similar to those used to do a biopsy. The seeds are harmless and can remain indeterminately in the patient’s body.
On the other hand, they do not lose effectiveness because they are detected in the same way months after their placement and do not migrate. Even the patient does not need to stay in the hospital after placement. Once the patient is in the operating room, a specific detection system (Sentimag®-Sysmex) is available, consisting of a detector and a probe, which when close to the seed generates an electromagnetic field detectable by the probe, plus or minus less potent depending on the proximity to the seed. This provides its location and, consequently, allows the tissue that contains it (lymph node or breast tumor) to be removed.
Most frequent cancer
Breast cancer is the most common neoplasm in women. At University Hospital of Gran Canaria Dr. Negrín are intervened for this reason, approximately 350 patients per year. Most of these patients undergo a conservative surgery, preserving the breast and armpit nodes, since it has been shown that with this treatment excellent oncological results and fewer physical, functional, psychological and aesthetic consequences are achieved.