Radioguided occult lesion localization (ROLL) of the nonpalpable breast lesions
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Original Article
VOLUME: 25 ISSUE: 1
P: 24 - 28
January 2009

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

Turk J Surg 2009;25(1):24-28
1. İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, Genel Cerrahi Anabilim Dalı Meme Hastalıkları Servisi, İstanbul
2. İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, Radyoloji Anabilim Dalı, İstanbul
3. İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, Nükleer Tıp Anabilim Dalı, İstanbul
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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.

Keywords:
ROLL, Radioguided occult lesion localization, non-palpable breast lesion

References

1
Feig SA. Decreased breast cancer mortality through mammographic screening: results of clinical trials. Radiology, 1988;167:659-665.
2
Altomare V, Guerriero G, Giacomelli L, et al. Management of nonpalpable breast lesions in a modern functional breast unit. Breast Cancer Res Treat 2005;93:85-89.
3
Moss HA, Barter SJ, Nayagam M, et al. The use of carbon suspension as an adjunct to wire localisation of impalpable breast lesions. Clin Radiol, 2002;57:937-944.
4
Kaufman CS, Jacobson L, Bachman B, et al. Intraoperative ultrasound facilitates surgery for early breast cancer, Ann Surg Oncol 2002;9:988-993.
5
Rose A, Collins JP, Neerhut P, et al. Carbon localisation of impalpable breast lesions, Breast 2003;12:264-269.
6
Bilgin MG, Sarı O, Balkan M, ve ark. Meme işaretleme yöntemiyle şüpheli lezyonların irdelenmesi. Meme Sağlığı Dergisi 2005;3:140-142.
7
Allen MJ, Thompson WD, et al. Management of non-palpable breast lesions detected mammographically. Br J Surg 1994;81:543-545.
8
Vuorela AL, Kettunen S, Punto L. Preoperative hook-wire localization of nonpalpable breast lesions by use of standard and stereotactic technique. Anticancer Res 1993;13:1873-1875.
9
Nadeem R, Chagla LS, Haris O, et al. Occult breast lesions: a comparison between radioguided occult lesion localisation (ROLL) vs. wire-guided lumpectomy (WGL). Breast 2005;14:283-289.
10
Gray RJ, Salud C, Nguyen K, et al. Randomized prospective evaluation of a novel technique for biopsy or lumpectomy of nonpalpable breast lesions: radioactive seed versus wire localization, Ann Surg Oncol 2001;9:711-715.
11
Paganelli G, De Cicco C, Luini A. Radioguided surgery in non-palpable breast lesions. Eur J Nucl Med 1997;24 (Suppl): 893P.
12
van der Ploeg IM, Hobbelink M, van den Bosch MA, et al. Radioguided occult lesion localisation' (ROLL) for non-palpable breast lesions: a review of the relevant literature. Eur J Surg Oncol 2008;34:1-5.
13
van Susante JL, Barendregt WB, Bruggink ED. Migration of the guide-wire into the pleural cavity after needle localization of breast lesions. Eur J Surg Oncol 1998;24:446-448.
14
Banitalebi H, Skaane P. Migration of the breast biopsy localization wire to the pulmonary hilus. Acta Radiol 2005;46:28-31.
15
Parker SH, Kercher JM, Dennis MA. Sonographically guided mammotome extraction of retained localization wire. AJR Am J Roentgenol 1999;173:903-904.
16
Mitnick JS, Vazquez MF, Harris MN, et al. Localization of transected wire. AJR Am J Roentgenol 1991;156:866.
17
Kaufman CS, Jacobson L, Bachman B, et al. Intraoperative ultrasound facilitates surgery for early breast cancer. Ann Surg Oncol 2002 ;9:988-993.
18
Rampaul RS, Bagnall M, Burrell H, et al. Randomized clinical trial comparing radioisotope occult lesion localization and wire-guided excision for biopsy of occult breast lesions. Br J Surg 2004;91:1575- 1577.
19
Luini A, Zurrida S, Paganelli G, et al. Comparison of radioguided excision with wire localization of occult breast lesions. Br J Surg 1999;86:522-525.
20
Zgajnar J, Hocevar M, Frkovic-Grazio S, et al. Radioguided occult lesion localization (ROLL) of the nonpalpable breast lesions. Neoplasma 2004;51:385-389.
21
Ronkä 2004 Rönkä R, Krogerus L, et al. Radio-guided occult lesion localization in patients undergoing breast-conserving surgery and sentinel node biopsy. Am J Surg 2004;187:491-496.
22
Sarlos D, Frey LD, Haueisen H, et al. Radioguided occult lesion localization (ROLL) for treatment and diagnosis of malignant and premalignant breast lesions combined with sentinel node biopsy: A prospective clinical trial with 100 patients. Eur J Surg Oncol 2008; doi:10.1016/j.ejso.2008.06.016.
23
Halaç M, Yılmaz MH, Aydoğan F. Palpe edilemeyen (okült) meme kanserlerinde sentinel lenf nodu biyopsisi. In: editörler: Uras C, Aydoğan F. Sentinel Lenf Nodu Biyopsisi. 1. baskı. İstanbul: İstanbul Tıp Kitabevi, 2007: 115-122.
24
Rampaul RS, Dudley NJ, Thompson JZ, et al. Radioisotope for occult lesion localisation (ROLL) of the breast does not require extra radiation protection procedures. Breast 2003;12:150-152.