Radioguided Occult Lesion Localization (ROLL) - New Technique for Pre-operative Localization of Non-palpable Breast Cancer

Full text: Aims: Mammographic screening and increasing resolution output of mammography have raised the identification number of small-size mammary lesions without clinical expression. In Romania, without organized breast cancer screening, such cases are rare and most of the times nearly discovered by chance. The aim of this study was to evaluate for the first time in Romania, in a prospective study ROLL and concomitant sentinel lymph node biopsy (SLNB). Methods: From 60 infra clinical breast lesions identified upon mammography, the 15 clinically occult breast cancers underwent preoperatively an injection of 99mTcnannocolloid under stereotaxic guidance. No additional wire localization was performed. Surgical excision was performed guided by the hand held gamaprobe. Sentinel lymph node was identified as an axillary hot spot on the probe. Results: All primary lesions were identified and were clear of invasive margins excised. The average specimen weight was 38g. The sentinel node was identified in 14 cases, and in 1 case it was tumor positive so that axillary clearance was mandatory. Conclusions: Using this technique, we removed in al cases the lesions identified by mammography, obtaining the necessary surgical treatment, a complete pathologic diagnostic and also prognostic data by axillary lymph node assessment. (author)