We present our evaluation and clinical experience with two innovative, radiation-free, wireless localisation techniques for non-palpable breast lesions: radiofrequency tags (LOCalizer™) and magnetic seeds (Magseed®). These emerging technologies offer a promising alternative to traditional wire-guided localisation (WGL), addressing significant challenges in breast cancer surgery. Wire-guided localisation, although widely used, presents several drawbacks, including patient discomfort, heightened anxiety, and logistical difficulties in coordinating radiological and surgical teams. Furthermore, recent evidence has demonstrated higher re-excision rates and increased healthcare costs associated with WGL compared to non-wire techniques. These limitations place both physical and emotional burdens on patients, while also straining healthcare systems. Following an audit in our department that revealed a 38% rate of positive margins in WGL cases—necessitating re-excision surgeries—we sought to explore innovative, non-wire alternatives. Our objective was to enhance scheduling flexibility, reduce re-excision rates, and improve overall patient outcomes. Our evaluation spanned from September 2021 to November 2022 for radiofrequency tags (RFT) and from May 2023 to November 2023 for magnetic seeds (Magseeds). We assessed successful insertion, identification and retrieval of the devices, surgical margin status, re-operation rates, and resected specimen weights. A comparative analysis was conducted using data from WGL cases during the same periods.

Results demonstrated that RFTs were successfully inserted in 10 breast lesions (6 malignant, 4 benign), and Magseeds were inserted in 31 lesions (20 malignant, 11 benign). Wires were used for 31 lesions (26 malignant, 5 benign). Insertion success rates were 100% for RFTs, 97% for Magseeds, and 97% for WGL. The average time from insertion to surgery was 19 days for RFTs (range: 6-55) and 16 days for Magseeds (range: 4-63), while wire localisation was performed on the day of surgery. Positive margins requiring re-excision were observed in 30.8% of WGL cases, compared to 16.7% in RFT cases and 15% in Magseed cases. Average specimen weights for malignant cases were 80.7 grams (WGL), 57 grams (RFT), and 28.7 grams (Magseeds).

Our findings support the adoption of non-wire localisation techniques, such as radiofrequency tags and magnetic seeds, as effective and efficient alternatives for the localisation of non-palpable breast lesions. These techniques not only reduce re-excision rates but also enhance patient comfort and streamline surgical workflows, representing a significant advancement in the precision of breast cancer surgery.