Background Radioactive seed localization (RSL) is an alternative to wire localization for guiding surgical excision of non-palpable breast cancer. This review provides an overview of the available evidence on the accuracy of RSL in patients undergoing breast-conserving surgery. Methods PubMed, Embase and the Cochrane Library were searched systematically in January 2012 for studies that addressed localization of non-palpable breast cancer using an iodine-125-labelled seed. Studies were deemed eligible if they reported on the proportion of patients with tumour-positive margins after RSL, the proportion of patients needing re-excision after RSL, and procedural complications. Results Six studies reported data on RSL in 1611 patients with non-palpable breast lesions. Overall complete resection rates ranged from 73 to 96·7 per cent. Three studies included over 300 patients, and complete resection rates in these studies varied between 89·5 and 96·7 per cent. The risk of seed migration and failure of seed placement ranged from 0 to 0·6 per cent and 0 to 7·2 per cent respectively. Conclusion Available scientific evidence suggests that RSL is a safe and accurate technique for localization of non-palpable breast lesions.
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