Radio-guided occult lesion localization for nonpalpable suspicious breast lesions: A novel technique

Background : Breast screening programs and increased self-awareness has led to increased identification of early breast cancers. Up to 25% of mammographicaly identified lesions are nonpalpable, which require a precise technique to localize and excise completely. Radio-guided occult lesion localization (ROLL) is a technique, which uses hand held gamma probe to accurately localize and completely excise occult beast lesions. ROLL can also be combined with sentinel lymph node biopsy (SLNB) for early breast cancers. This is a minimally invasive approach with least morbidity and better patient compliance. Materials and Methods : 25 cases underwent ROLL for nonpalpable breast lesions. 99m Tc-sulphur colloid was injected into the center of the lesion under ultrasound guidance preoperatively. No guidewire localization was performed. Under general anesthesia, surgical excision of the lesion was carried out using the hand-held gamma probe. Fifteen patients were diagnosed with early breast cancer with clear margin status. These patients also underwent SLNB at the same procedure. Results : Fifteen out of 25 cases were found to harbor invasive breast cancer. The pathological margins were clear of tumor in all of these patients. The sentinel node was identified in all cases. In four out of the 15 cases, sentinel node harbored occult metastases. Conclusion : ROLL is a useful method for precise, three-dimensional localization of impalpable breast tumors with results comparable to those achieved by surgery of palpable lesions. Furthermore, ROLL is feasible in connection with sentinel node biopsy in the same setting. It is performed as a day-care procedure with good cosmesis

Radio-guided occult lesion localization for nonpalpable suspicious breast lesions: A novel technique

Background : Breast screening programs and increased self-awareness has led to increased identification of early breast cancers. Up to 25% of mammographicaly identified lesions are nonpalpable, which require a precise technique to localize and excise completely. Radio-guided occult lesion localization (ROLL) is a technique, which uses hand held gamma probe to accurately localize and completely excise occult beast lesions. ROLL can also be combined with sentinel lymph node biopsy (SLNB) for early breast cancers. This is a minimally invasive approach with least morbidity and better patient compliance. Materials and Methods : 25 cases underwent ROLL for nonpalpable breast lesions. 99m Tc-sulphur colloid was injected into the center of the lesion under ultrasound guidance preoperatively. No guidewire localization was performed. Under general anesthesia, surgical excision of the lesion was carried out using the hand-held gamma probe. Fifteen patients were diagnosed with early breast cancer with clear margin status. These patients also underwent SLNB at the same procedure. Results : Fifteen out of 25 cases were found to harbor invasive breast cancer. The pathological margins were clear of tumor in all of these patients. The sentinel node was identified in all cases. In four out of the 15 cases, sentinel node harbored occult metastases. Conclusion : ROLL is a useful method for precise, three-dimensional localization of impalpable breast tumors with results comparable to those achieved by surgery of palpable lesions. Furthermore, ROLL is feasible in connection with sentinel node biopsy in the same setting. It is performed as a day-care procedure with good cosmesis