Breast Seed Localization

Cornwall community hospital recently became one of few hospitals in Canada to offer a procedure called Breast Seed Localization (BSL), a more comfortable and efficient alternative to wire localization, to pinpoint and remove nonpalpable tumours.

Click here to learn more about how CCH brought this landmark breast cancer technology to our community, or see below for frequently asked questions.

What is Breast Seed Localization?

Breast seed localization (BSL) is a procedure that prepares a patient for breast surgery.

The procedure is done 1 to 2 weeks before the scheduled surgery, in either mammography or ultrasound. During the procedure, the radiologist will insert a very small, titanium coated, low dose radioactive seed (about the size of a sesame seed) into the breast tumour or tissue.

During your surgery, the radiation from the seed will help the surgeon identify and find the concerning breast tissue. The surgeon will then remove both the breast tissue and the seed.

How is the seed inserted?

Mammogram or ultrasound imaging will allow the radiologist to determine where the abnormal tissue is located. Once the radiologist sees where the abnormal tissue is, they will give you an injection of local anesthetic close to the area. After the area is numb, the radiologist will insert a needle with the seed inside of it into your breast, the seed will be placed into the tissue and your doctor will remove the needle. The seed will stay in your breast until your surgery.

When does the seed get inserted?

You will have an appointment at CCH 1 to 2 weeks prior to your surgery for the implantation of the seed. A radiologist who has been specially trained in this procedure performs the seed implantation.

Can I go home once the seed is inserted?

Yes, patients can return home until their scheduled surgery.

What are the differences between wire localization and seed localization?

Wire localization has long been the main method of nonpalpable tumour localization used at most hospitals. Patients require a wire to be inserted into their breast tissue the day of their surgery. The wire marks where the surgeon has to remove tissue.

With BSL, a radiologist injects a small radioactive seed (about the size of a sesame seed) into the patient’s breast tissue 1 to 2 weeks before surgery. Unlike wire localization, the patient cannot feel the seed once it’s in place and can return home comfortably until surgery.

During the surgery, the surgeon uses a handheld device that detects radioactivity to more precisely identify the location of the tumour containing the seed. The surgeon is able to more accurately plan the surgical incision as the radioactive seed allows them to determine the precise location of the tumour and its exact size.

How much radioactivity is in the seed and is it safe?

The radioactive seed is coated in titanium; the total exposure to radiation from the seed being in your breast tissue for a duration of up to 2 weeks is about the same as a standard mammogram and less than most x-ray studies.

You are not required to isolate or wear special garments to block radiation exposure. The items you touch and clothes that you wear won’t become radioactive. You may continue going to work, visiting friends and family, going out in public, etc.

People who are in close physical contact with you may be exposed to very small amounts of radiation, however there isn’t any evidence that this exposure is harmful.

Because you will be exposed to a very small amount of radiation from the seed, we don’t recommend you hold a baby, child, or young animal against your chest for any longer than 30 minutes per day until the seed is removed during surgery. 

My doctor has scheduled me for a wire localization procedure at CCH. Will the procedure now be conducted using breast seed localization?

Wire localization procedures will continue at CCH alongside breast seed localization procedures. Your doctor will work with you to determine which procedure would be best based on your care plan and specific needs. If you are scheduled for a wire localization procedure, it will remain as such unless your doctor orders a breast localization procedure.