Breast surgery

Magtrace Can Sustainably Improve Theatre Efficiency, Operative Capacity, and Patient Experience (2024)

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Type of publication:

Conference abstract

Author(s):

*Lake B.; *Wilson M.; *Appleton D.

Citation:

Annals of Surgical Oncology. Conference: 25th American Society of Breast Surgeons Annual Meeting, ASBrS 2024. Orlando, FL United States. 31(Supplement 2) (pp S498), 2024. Date of Publication: 01 Jun 2024.

Abstract:

Background/Objective: Magtrace is an iron oxide liquid which has revolutionized sentinel lymph node biopsy treatment for breast cancer. It has a flexible injection window which allows patients to have the injection prior to the day of surgery at a convenient time for both the patient and the provider and removes the need for nuclear medicine completely. Magtrace was reviewed by the National Institute for Health and Care Excellence in October 2022 (MTG72) and they highlighted that Magtrace has the potential to reduce cost based on an expectation that its usage would enable hospitals to perform additional sentinel node biopsies due to improved operating room utilization. The National Institute for Health and Care Excellence (NICE) provides national guidance and advice to improve health and social care in the UK. This guidance is the gold standard for advice for breast cancer treatment. Our team designed a study to investigate the "additive effect" of Magtrace in improving theatre efficiency, operative capacity, and patient experience (Presented at European Society of Surgical Oncology, to be published in European Journal of Surgical Oncology early 2025). The aim of this study was to assess if these previously described benefits of Magtrace by NICE are sustained in a hospital system. Method(s): All Magtrace cases for sentinel node biopsy at the Shrewsbury & Telford NHS Trust were prospectively recorded. The outcomes measured were operating room utilization, number of sentinel node biopsies performed per week, and patient satisfaction. Result(s): 150 patients undergoing a wide local excision or mastectomy received Magtrace as the sole technique for SLNB. Operating room utilization improved from 77% to 84% (with peak utilisation at 96%) due to a reduction in OR delays and improved OR flow. Previous delays were caused by patients waiting to have radioisotope injections. Significantly more sentinel node biopsies were performed per week, increasing from 6.48 per week (Pre Magtrace 2022) to 8.57 per week (Post Magtrace ) (t-value = 3.53057, p-value < 0.00041). This resulted in a net increase of 2 additional patients per week. The t-value is 3.53057. The p-value is .00041. The result is significant at p < 0.05. The study showed high patient satisfaction with 100% of patients finding injection more convenient on the day of surgery and 100% of patients would recommend Magtrace to a friend or relative. Conclusion(s): Utilising Magtrace for sentinel lymph node biopsy creates a sustained "additive effect" by improving operating room utilization, operating room capacity and demonstrates a high patient satisfaction.

DOI: 10.1245/s10434-024-15410-w

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Magseed for Localisation of Impalpable Breast Cancer is associated with High Patient Satisfaction and Lower Re-excision Rates (2019)

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Type of publication:
Poster presentation

Author(s):
*L.Deane, *B.Lake, *M.Wilson, *S.Williams, *M.Metelko, *G.Thomas, *S.Lewis, *L.Norwood, *T.Usman

Citation:
Poster presented at the International Cambridge Conference on Breast Cancer Imaging, July 2019

Link to poster [PDF]

Breast reconstruction affects coping mechanisms in breast cancer survivors (2017)

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Type of publication:
Journal article

Author(s):
*Lake, B., Fuller, H.R., *Rastall, S, *Usman, T

Citation:
Indian Journal of Surgery, December 2017

Abstract:
Coping strategies used by women with breast cancer are vital for adjustment to their disease. Whilst it is clear that factors such as age at diagnosis, social support and ethnicity can influence coping mechanisms, there is currently no information about whether breast reconstruction changes mechanisms of coping for such patients. The aims of this study, therefore, were to determine how women who have had immediate breast reconstruction and mastectomy cope, compared to those who have mastectomy alone, and whether there are differences in coping mechanisms due to breast reconstruction surgery. This was a retrospective cohort study, using a standardised questionnaire called the Brief Cope Scale. Inclusion criteria was the following: all women who had immediate breast reconstruction and mastectomy in Shropshire from 2003 to 2014 for ductal carcinoma in situ or node-negative invasive breast cancer. Each patient was matched for year of diagnosis, adjuvant therapy and age to one woman who had mastectomy alone. Two hundred thirty-four questionnaires were sent with a 58% response rate. Significantly more patients from the reconstruction cohort coped by active coping (T value 1.66, P value 0.04) compared to those in the mastectomy alone cohort. In contrast, significantly more patients in the mastectomy alone cohort coped by active venting compared to the reconstruction cohort (T value 1.71, P value 0.04). This study indicates for the first time that breast reconstruction may alter coping mechanisms in breast cancer survivors. Awareness of these coping mechanisms will enable clinicians to provide appropriate, individualised support.