Wireless localisation of breast lesions with MagSeed. A radiological perspective of 300 cases.

OBJECTIVES: The purpose of this article is to review the technical and radiological aspects of MagSeed® localisation, to assess its accuracy based on post-localisation mammograms and excision specimen X-rays and to discuss the radiological experience of our institutions. METHODS: Two-year data were collected retrospectively from three NHS boards from the West of Scotland. A total of 309 MagSeeds® were inserted under mammographic or ultrasonographic guidance in 300 women with unifocal, multifocal and/or bilateral breast lesions at the day of surgery or up to 30 days prior to it. Radiological review of post-localisation mammograms and intraoperative specimen X-rays as well as a review of the surgical outcomes were performed to assess the accuracy and efficacy of the method. Our experience relating to the technique's strengths and downsides were also noted. RESULTS: The MagSeeds® were inserted on average 7.2 days before surgery. The localisation technique was straight forward for the radiologists. In 99% of the cases, the MagSeed® was successfully deployed and 100% of the successfully localised lesions were excised at surgery. There was no difference in the accuracy of the localisation whether this was mammographically or ultrasonographically guided. On post-localisation mammograms, the MagSeed® was radiologically accurately positioned in 97.3% of the cases. No delayed MagSeed® migration was observed. On the specimen X-rays, the lesion was centrally positioned in 45.1%, eccentric within more than 1 mm from the margin in 35.7% and in 14.8% it was at the specimen's margin. The re-excision rate was 18.3%. CONCLUSION: The MagSeed® is an accurate and reliable localisation method in breast conserving surgery with good surgical outcomes. ADVANCES IN KNOWLEDGE: To our knowledge, the radiological aspects of MagSeed® localisation have not been widely described in peer-reviewed journals thus far.

'Creating health': evaluation of three arts for health training events for GP trainees.

BACKGROUND: General practitioners (GPs) and other health professionals have a key role in signposting their patients to appropriate opportunities for engaging in arts and creative activities for the health and wellbeing benefits they may bring. Training is needed to ensure that GPs are aware of the evidence supporting the role of the arts, and the local availability of 'creative arts for health' activities for their patients. AIM: This article describes the content and evaluation of three arts and health training events for trainee GPs conducted over the period 2016-2019. They took place in association with Guy's and St Thomas, Hillingdon and York and Scarborough General Practice Vocational Training Schemes (GPVTS). METHODS: Evaluation was undertaken for the London events using a specially constructed questionnaire, with rating scales, completed before and after the training events. For the York event, a simple bespoke evaluation questionnaire was employed at the end of the training day. All participants gave consent for photography and filming during the events. RESULTS: Feedback from GPs on the training events revealed increased awareness of the evidence for arts and health interventions, and more positive attitudes towards the role of creative arts in primary care in promoting the health and wellbeing of patients. An additional finding was a recognition by GP trainees that creative activities can enhance a holistic approach to patient care and play a positive part in supporting their own wellbeing. CONCLUSION: Training events of the kind described, with opportunities for creative participation for GP trainees, can enhance awareness of the benefits of creative activity for patient health and wellbeing, and may motivate future GPs to signpost patients towards opportunities for engaging in creative activities. This training model is applicable for any health worker who can refer patients to arts for health activities and has potential to be scaled up nationally.