Breast Radioactive Seed Localization (RSL)

What is Radioactive Seed Localization (RSL)?

RSL is a procedure used when an area of breast tissue that needs removing, cannot be felt by examination and the surgeon needs a guide to ensure he removes the correct piece of tissue during surgery. Radioactive seeds are tiny metal radioactive seeds (about the size of an ice cream sprinkle) that are inserted into the breast tissue by the radiologist (A doctor who specialises in x -ray) while you have an ultra sound scan or mammogram. The procedure can be done a week or two before your surgery. It will involve attending the breast screening unit as an outpatient.

What are the benefits of RSL?

RSL gives the surgeon a more accurate location of the breast tissue that needs removing.

The seed can be inserted a week or two before your surgery. 

What are the alternatives to RSL?

The alternative method to this procedure is a guidewire procedure which involves inserting a small fine wire into your breast under ultrasound/mammogram which will then be a guide to the surgeon when he removes the tissue. This would need to be done on the day of your surgery.

What does the procedure involve?

The seed is inserted by a radiologist. The procedure is similar to the core needle biopsy you will have had to your breast that confirmed your diagnosis. You will attend the breast unit and have an ultrasound scan or mammogram of your breast to locate the cancer. The radiologist will then inject a local anaesthetic (numbing medicine) into your breast. This may sting for a few seconds but will numb your breast quickly. The radiologist will then use a small thin needle to place the seed into the area of cancer that needs removing. You may feel some pressure in your breast during the procedure but is not normally painful. If you do feel any pain, please make the staff aware so that more local anaesthetic can be given. You will not be able to feel the seed once it is inserted. A small dressing will be placed over the puncture site. The procedure will usually take about 30minutes.

What are the risks of RSL?

You may have some mild discomfort and bruising. If you do have discomfort or pain then you can take your regular pain relief.

You may have a small amount of bleeding on your dressing. This is normal. If you have any heavy bleeding that soaks through your dressing apply firm pressure. If this continues and you are concerned you can contact your breast care nurse.

If you have any signs of infection such as a high temperature, redness then contact your breast care nurse.

The radioactive seeds only give off a small amount of radiation and are not harmful to the rest of the body or to others. Once you have surgery and the seed is removed the radiation is gone and the seed is disposed of by the radiologist.

If you are planning to travel by aeroplane while your seeds are in your breast you will need a letter from your breast care nurse to take with you as you may set off the alarms at security.

What happens after the seed localization?

You can remove the dressing after 24hrs. You can return to work and most activities the following day. Avoid heavy lifting for 24 hrs. You may shower the follow day but do not soak in a bath or go into a swimming pool for 48hrs. It is recommended that you wear a comfortable supportive bra for 24hours.  

What happens during surgery?

During surgery while you are asleep under general anaesthetic, the surgeon will use a probe to identify the seed and location of the breast tissue that needs removing. The surgeon will then proceed with your surgery.

Who do I contact if I have any concerns?

If you have any concerns Monday- Friday 8am-5pm you can contact your breast care nurse. You will have her contact number in your green booklet and you will also have her contact card.

If you have any problems out of hours or weekends then you can telephone 111 (NHS non emergence contact number).

Data Protection.

Any personal information is kept confidential.  There may be occasions where your information needs to be shared with other care professionals to ensure you receive the best care possible.

In order to assist us to improve the services available, your information may be used for clinical audit, research, teaching and anonymised for National NHS Reviews and Statistics.  

Further information is available via Gateshead Health NHS Foundation Trust website or by contacting the Data Protection Officer by telephone on 0191 445 8418 or by email ghnt.ig.team@nhs.net.

This leaflet can be made available in other languages and formats upon request