New Seed Implantation Procedure Improves Breast Cancer Surgery Outcomes

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Mount Sinai's Dubin Breast Center is performing a cutting-edge procedure available at only a handful of institutions around the U.S. called seed localization. This procedure allows surgeons to better target and remove small breast tumors.

A cutting-edge procedure called seed localization is improving patient satisfaction at The Dubin Breast Center of the Tisch Cancer Institute at The Mount Sinai Medical Center. In patients undergoing lumpectomy for cancers that are small and cannot be felt in the breast, a tiny radioactive seed is guided into the breast and implanted at the site of the tumor. The seed allows surgeons to better target and remove small breast tumors. This procedure is only available at a few centers in the country since its implementation involves significant coordination between a specialized team of breast surgeons and OR personnel, radiologists, nuclear medicine physicians and pathologists.

Prior to the development and implementation of seed localization, targeting small tumors could only be done with a procedure called needle localization. In this presurgical procedure a wire is guided to the site of the tumor using advanced imaging technology. Because the wire protrudes from the skin, this procedure was always performed on the day of surgery and remained in place until removed at surgery.

“Thankfully, with mammography and our advanced imaging techniques we are picking up tumors that are smaller and earlier than ever before,” said Elisa Port, MD, Chief of Breast Surgery and Co-Director of the Dubin Breast Center. “Seed localization is another, more patient-friendly tool to specifically target the cancer and minimize the amount of time a patient spends in the hospital and in preparation on the day of surgery.”

With seed localization, the seed is implanted in the days leading up to surgery, so that the patient does not have to arrive at the hospital hours before surgery, as they do with needle localization. Using local anesthesia in an exam room, the seed is guided into position using a pre-loaded needle and then implanted at the site of the tumor by a specialized breast radiologist. Patients do not have to fast prior to the placement of the seed, and the procedure is performed with minimal discomfort.

When the patient returns days later to have the tumor removed at surgery, she does not need to undergo the needle localization process, and instead goes straight to surgery. The surgical team uses a specialized handheld probe that detects the radioactive signal given off by the seed, allowing the surgeon to zero in and remove the target along with the adjacent tumor. No radioactivity remains within the breast once the tumor and seed are removed.

“With 3D mammography and now with seed localization, the Dubin Breast Center is continuously working to ensure our patients have access to the best, most advanced technology in breast cancer detection and treatment,” said Laurie Margolies, MD, Associate Professor of Radiology and Chief of Breast Imaging at The Mount Sinai Medical Center. “Seed localization allows our surgeons to precisely remove cancerous tissue, reduces the volume of tissue required for removal, and greatly improves our patients’ experience.”

To learn more about the Dubin Breast Center, visit

About The Mount Sinai Medical Center

The Mount Sinai Medical Center encompasses both The Mount Sinai Hospital and Mount Sinai School of Medicine. Established in 1968, Mount Sinai School of Medicine is one of the leading medical schools in the United States. The Medical School is noted for innovation in education, biomedical research, clinical care delivery, and local and global community service. It has more than 3,400 faculty in 32 departments and 14 research institutes, and ranks among the top 20 medical schools both in National Institutes of Health (NIH) funding and by US News and World Report.

The Mount Sinai Hospital, founded in 1852, is a 1,171-bed tertiary- and quaternary-care teaching facility and one of the nation’s oldest, largest and most-respected voluntary hospitals. In 2011, US News and World Report ranked The Mount Sinai Hospital 16th on its elite Honor Roll of the nation’s top hospitals based on reputation, safety, and other patient-care factors. Of the top 20 hospitals in the United States, Mount Sinai is one of 12 integrated academic medical centers whose medical school ranks among the top 20 in NIH funding and US News and World Report and whose hospital is on the US News and World Report Honor Roll. Nearly 60,000 people were treated at Mount Sinai as inpatients last year, and approximately 560,000 outpatient visits took place.

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