A Prospective, Single Arm, Multi-site, Clinical Evaluation of a Nonradioactive Surgical Guidance Technology for the Location of Nonpalpable Breast Lesions during Excision.

OBJECTIVES: This study was a multicenter evaluation of the SAVI SCOUT(®) breast localization and surgical guidance system using micro-impulse radar technology for the removal of nonpalpable breast lesions. The study was designed to validate the results of a recent 50-patient pilot study in a larger multi-institution trial. The primary endpoints were the rates of successful reflector placement, localization, and removal. METHODS: This multicenter, prospective trial enrolled patients scheduled to have excisional biopsy or breast-conserving surgery of a nonpalpable breast lesion. From March to November 2015, 154 patients were consented and evaluated by 20 radiologists and 16 surgeons at 11 participating centers. Patients had SCOUT(®) reflectors placed up to 7 days before surgery, and placement was confirmed by mammography or ultrasonography. Implanted reflectors were detected by the SCOUT(®) handpiece and console. Presence of the reflector in the excised surgical specimen was confirmed radiographically, and specimens were sent for routine pathology. RESULTS: SCOUT(®) reflectors were successfully placed in 153 of 154 patients. In one case, the reflector was placed at a distance from the target that required a wire to be placed. All 154 lesions and reflectors were successfully removed during surgery. For 101 patients with a preoperative diagnosis of cancer, 86 (85.1 %) had clear margins, and 17 (16.8 %) patients required margin reexcision. CONCLUSIONS: SCOUT(®) provides a reliable and effective alternative method for the localization and surgical excision of nonpalpable breast lesions using no wires or radioactive materials, with excellent patient, radiologist, and surgeon acceptance.

Effect of feeding flax or linseed meal on progesterone clearance rate in ovariectomized ewes.

Ovariectomized ewes (n=22; 68.76+/-2.34 kg initial body weight; 2.9+/-0.1 initial body condition score) were individually fed one of three diets: (1) control (phytoestrogen-free; n=7), (2) flax containing diet (n=8), or (3) linseed meal (LSM) containing diet (n=7) to investigate the rate of progesterone (P4) clearance. On day 20 of feeding (day 0=initiation of treatment), a P4 releasing device (CIDR) was placed in the vagina and jugular blood samples were obtained prior to CIDR insertion and 15, 30, 60, and 120 min following CIDR insertion. Further, blood samples were obtained daily between days 21 and 24. On day 25, blood samples were retrieved prior to CIDR removal and 2, 5, 10, 15, 30, 60, 120, and 360 min following CIDR removal. There was no difference in initial or final body weight or body condition score and there were no time by diet interactions on P4 clearance. The fractional rate of P4 uptake measured prior to CIDR insertion through day 4 following insertion tended to be greater (P=0.07) in LSM fed ewes (508.75+/-71.37%/min) compared to flax (295.39+/-66.76%/min) and control fed (287.54+/-71.37%/min) ewes. Diet tended (P=0.10) to influence P4 clearance rate when measured from prior to CIDR removal through 120 min following CIDR removal with LSM fed ewes having a greater (1.26+/-0.2) fractional rate constant than flax (0.929+/-0.09) and control fed (0.922+/-0.09) ewes. Flax fed ewes also had more (P<0.01) omega-3 fatty acids and total fatty acids in plasma. Reports of increased pregnancy rates in dairy cows fed flax may relate to P4 metabolism.