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The Safe Use of ¹²⁵I-Seeds as a Localization Technique in Breast Cancer during Pregnancy

The Safe Use of ¹²⁵I-Seeds as a Localization Technique in Breast Cancer during Pregnancy

Eva Heeling ¹, Jeroen B van de Kamer ², Michelle Methorst ³, Annemarie Bruining ⁴, Mette van de Meent ⁵, Marie-Jeanne T F D Vrancken Peeters ¹, Christianne A R Lok ³, Iris M C van der Ploeg ¹

Eva Heeling ¹, Jeroen B van de Kamer ², Michelle Methorst ³

¹Department of Surgical Oncology, Netherlands Cancer Institute Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
²Department of Radiation Oncology, Netherlands Cancer Institute Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
³Department of Gynaecologic Oncology, Netherlands Cancer Institute Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
⁴Department of Radiology, Netherlands Cancer Institute Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
⁵Department of Obstetrics, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.

⁰Department of Surgical Oncology, Netherlands Cancer Institute Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.

Cancers +

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June 28, 2023

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View abstract on PubMed

Summary

This summary is machine-generated.

Iodine-125 seeds are safe for localizing breast cancer during pregnancy (PrBC). Fetal radiation exposure remains below harmful levels, especially when surgery is timely, ensuring patient and fetal safety.

Area Of Science

Oncology
Radiology
Maternal-Fetal Medicine

Background

Treatment protocols for breast cancer during pregnancy (PrBC) require further investigation.
The safety of using Iodine-125 (<sup>125</sup>I) seeds for localization in PrBC surgery is not fully established.

Purpose Of The Study

To assess the safety of <sup>125</sup>I-seed localization for breast-conserving surgery in pregnant patients with breast cancer.
To quantify fetal radiation exposure from <sup>125</sup>I-seeds during pregnancy.

Main Methods

A model was developed to calculate fetal radiation exposure from a single <sup>125</sup>I-seed.
The model considered seed decay, time to surgery, and seed-fetal distance.
Maximum cumulative fetal dose was determined at various gestational ages (GA).

Main Results

Fetal dose is below 1 mSv if a single <sup>125</sup>I-seed is implanted at or before 26 weeks GA.
Post-26 weeks GA, maximum fetal dose can reach 11.6 mSv.
Doses remain below 1 mSv with timely surgery (within 2 weeks post-implantation at 26 weeks GA, or 1 week post-implantation above 32 weeks GA).

Conclusions

<sup>125</sup>I-seed use is deemed safe for PrBC patients.
Maximum fetal exposure is significantly below the 100 mSv threshold, minimizing fetal tissue damage risk.
Maintaining fetal dose below 1 mSv is recommended whenever feasible.

Keywords:

breast cancer breast-conserving surgery fetus iodine-125 seeds pregnancy radiation

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