Breast biopsy marking
The majority of the suspicious lesions detected by screening mammography are small nonpalpable lesions, i.e. mass lesions or calcifications. Biopsy are performed to differentiate between benign and malignant lesions and decide if surgical removal is needed.
It is helpful to mark these lesions with a marker (clip) which can be implanted during the initial biopsy procedure or in a second step. Clip-marking is done in order to prove the correct location of the biopsy and to guide the surgeon for the excision.
Clip-marking can also be useful for the follow up of suspicious lesions with benign histology.
Click here for the Gold Anchor breast biopsy marker brochure
Mammogram showing Gold Anchor implanted in breast to mark a biopsy site
Ultrasound image showing Gold Anchor implanted in breast to mark a biopsy site
Before surgery, these clips are usually used for guide wire placement. Exact positioning of the clips within or right next to the lesion helps to reduce the size of tissue that should be surgically removed. For some tumors neoadjuvant treatment (i.e. chemotherapy and/or hormone treatment before surgery) is used for downsizing the tumor prior to surgery. Clip-marking in these cases is important in order to define the area of breast tissue which must be removed.
There are guidelines supporting the placement of markers for breast biopsy:
American College of Radiology (ACR): https://www.acr.org/-/media/ACR/Files/Practice-Parameters/US-GuidedBreast.pdf
The American Society of Breast Surgeons (ASBrS): https://www.breastsurgeons.org/docs/statements/Consensus-Guideline-on-Image-Guided-Percutaneous-Biopsy-of-Palpable-and-Nonpalpable-Breast-Lesions.pdf
Gold Anchor is ideal for breast biopsy marking with its unique and patented design.
The Gold Anchor markers are pre-loaded in industry leading thin 20G needles.
When deployed, Gold Anchor expands outside the needle and attaches immediately into the tissue.
Gold Anchor can be implanted percutaneously, guided by stereotactic mammography, ultrasound or CT.
Radiation therapy for breast cancer
Radiation therapy is commonly used in the treatment of breast cancer for example for adjuvant therapy after surgery. It is common to mark the surgical cavity after lumpectomy with surgical clips that can be visualized on CBCT. Those clips, however, may not provide sufficient visibility for automated marker tracking systems. Additionally, it is sometimes difficult to attach these markers to the tumor bed.
Ultrahypofractionation and radiotherapy boost treatments are becoming more and more common as well as the delineation of the target area on MRI. Gold Anchor markers provide strong tissue attachment in the tumor bed and provide good visibility both on kV and MR images.
Gold Anchors can be implanted during surgery to mark the surgical cavity after lumpectomy. The markers can then be used to improve accuracy in delineation of the surgical cavity and for the verification of breast position during IGRT.
Image guidance may improve whole breast irradiation outcomes by ensuring adequate coverage of the target tissue on a daily basis while allowing smaller margins around the targets, thereby reducing exposure to lung and heart (for left sided cases).
Marker based IGRT is also useful for APBI (Accelerated Partial Breast Irradiation) for example with CyberKnife as shown in the image to the right. .
Gold Anchor can also be placed percutaneously in breast, e.g. to facilitate a boost to breast tumors prior to surgery.
“We started using Gold Anchor in 2017 and have used it in more than 100 breast patients. Patients have tolerated this procedure very well with minimal discomfort. We also like being able to scan the patient the same day and our patients appreciate not having to return for another visit especially during COVID.“
Gold Anchor can also be used for proton therapy treatments of breast.
The ultrathin Gold Anchor markers cause very low dose perturbation.
Image to the left showing two 0.28×10 mm Gold Anchor markers implanted.