Radioguided occult lesion localization (ROLL) of the nonpalpable breast lesions

Abstract

Radioguided occult lesion localization (ROLL) of the nonpalpable breast lesions

Purpose: The incidence of non-palpable breast lesions has been significantly increased because of widespread use of breast screening techniques and the fact that women are becoming more conscious about breast cancer. Standard method for localization of nonpalpable lesions is the wire localization.The aim of this study is to present the results of ROLL (Radioguided occult lesion localization) which is a new technique in our clinic for localization of non-palpable lesions.

Patients and Methods: ROLL was performed for 260 patients (from December 2004 to August 2008) who had radiologically suspicious lesion. In the time period 24 hours before surgery all patients had an injection of 1-2 mci Tc-99m labelled Human Serum Albumin in 0.2- 0.5 cc saline directly into the lesion under ultrasound or stereotacticly. The excision was made in the operating room with the help of gama probe. All excision materials were evaluated with heamatoxylene & eosine staining and parafine cross sections.

Results: In 255 patients out of 260 (98%) the non-palpable lesion was correctly localized with ROLL and excized. In 3 patients the injected contrast material was seen to disperse in the duct and in 1 patient it did not cover the lesion.There was residual microcalcification postoperatively in 1 patient. In pathologic evaluation the lesion was found to be benign in 175 patients (68.7%) and malignant in 80 patients (31.3%).

Conclusion: ROLL is a safe and easily performed method for localization of non-palbable breast lesions. Because of the fact that the localization with ROLL can be performed one day before surgery, it is a better alternative than wire localization.