Introduction of Magseed into breast cancer surgery

Breast cancer is the most common form of cancer occurring in Australian women; each month within Murrumbidgee Local Health District (MLHD), there are on average six resections of cancerous breast tumours. This rate has been growing annually by 1.5%.

Until recently, the standard approach for woman having lumpectomy surgery in NSW has been the use of hook wire localisation and radioisotope sentinel node excision, where by a wire is inserted into the tumour by a radiologist on the day of surgery. There are periods when the patient is not anaesthetised with the wire still in-situ, which can be considerably uncomfortable for the patient. There is also a risk for the wire to shift before surgery, which can result in the surgeon having trouble locating the tumour, reducing the chance of the successful removal of all the diseased tissue.

Introducing Magseed technology

Magseed is a new seed technology that is more accurate than the use of wires and easier for the surgeon to find. Magseed is a metallic seed, no bigger than a grain of rice, that can be implanted into a lesion up to 30 days prior to surgery. Magseed implantation takes a few minutes under ultrasound or mammography guidance.

The ability to place Magseed prior to theatre removes the logistical problem of requiring a radiologist to place the guide wire on the day of surgery, with the unique magnetic sensing system allowing the surgeon to find the Magseed and lesion more accurately. From January 2010 to November 2019, there were 651 lesions resected and 110 (16.9%) occasions upon which further surgery was required on the lesion across MLHD. This resulted in 147 bed days and a total cost of $568,192. This 16.9% of revision surgeries could potentially be improved by the use of Magseed.

A helping hand from community

Prior to implementation, the project team mapped out the costs involved in both procedures, both short-term and long-term, considering costs of patient beds and theatre time, as well as repeat operations. Current and projected patient pathways were presented to the Director of Medical Services, who agreed the project was worthwhile in progressing.  A decision memorandum was submitted to the CEO of MLHD, and in collaboration with the local clinical governance lead, a New Technology application was submitted to NSW Health.

After approval, funding for the seed machine was successfully secured from local breast cancer organisation, Griffith Breast Cancer Support Group. In April 2022, Griffith Base Hospital (GBH) successfully implemented Magseed into practice, replacing the hook wire localisation technique. The technology has now been in place for 18 months.

Use of Magseed expanding after initial success

At GBH, using the Magseed technique for localisation of breast lesions has shown to be more cost effective than wires by creating efficiencies in theatre, reducing re-excision rates and length of stay. At GBH, the average time to excise a lesion (knife to skin to lesion excised) was 24 minutes using a Magseed, compared to wire insertion which on average can take up to 90 minutes. Results found in published studies include reduction in time spent in hospital on day of surgery, reduction in local pain pre-op on day of surgery, reduction in time waiting between wire, radioisotope and surgery, increased number of patients who can have surgery locally and eliminate exposure to radioactive material. ¹ With the success of introducing the Magseed technology at GBH, MLHD is now planning to replicate the implementation of this technology at Wagga Wagga Rural Referral Hospital.

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