Women with invasive breast cancer in the UK will now be injected with a magnetic marker liquid that will help surgeons discover if cancer has spread, according to a recommendation by the government's health advisers shared on Tuesday. The magnetic liquid tracer - Magtrace - is a non-radioactive dark brown liquid. It is both a magnetic marker and a visual dye. Magtrace is injected into the tissue around a tumour. The particles are then absorbed into the lymphatic system, following the route that cancer cells are most likely to take when they spread from the primary tumour and become trapped in sentinel lymph nodes.
The National Institute for Health and Care Excellence (NICE), which advises ministers and the NHS, has issued draft guidance endorsing the use of Magtrace in conjunction with a probe called Sentimag.
The Sentimag probe moves over the skin emitting sounds of different pitches as it passes over the Magtrace tracer, in a similar way to a metal detector locating metal in the ground. The nodes often appear dark brown or black in colour, which also helps with identification. Once the sentinel lymph node is located, the surgeon makes a small incision (about 1/2 inch) in the overlying skin and removes the node for biopsy.
The sentinel node is then checked for the presence of cancer cells by a pathologist. If cancer is found, the surgeon may remove additional lymph nodes, either during the same biopsy procedure or during a follow-up surgical procedure.
"People with breast cancer want to know if their cancer has been isolated or has spread to the rest of their body. The earlier this is established, the better the potential outcomes will be," said Jeanette Kusel, acting director for MedTech and digital at NICE, in a statement.
Surgeons working in hospitals with limited or no access to a radiopharmacy department can now use Magtrace and Sentimag as an option to locate sentinel lymph nodes in people with breast cancer. The procedure may be also done on an outpatient basis or may require a short stay in the hospital, unlike the current treatment which requires hospitals to have a daily supply of radioactive isotope or availability of nuclear medicine staff.
Also, Magtrace can be injected 20 minutes before a biopsy, or up to 30 days before surgery. This is likely to mean people can be injected at a pre-operation appointment.
"The benefits of using this technology include the potential for more procedures to take place, reducing the reliance on radioactive isotopes shipped into the country and for less travel for people having a biopsy," Kusel said.