Impact of radioguided occult lesion localization on the correct excision of malignant breast lesions: effect of histology and tumor size

Woll, J.P. Pilkington; Romera, M. Cortés; Vicente, Ana María García; García, B. González; Portela, M. Delgado; García, J.M. Cordero; García, Ricardo Pardo; Trinidad, C. Molino; Castrejón, Á.M. Soriano

doi:10.1007/s12149-010-0453-z

Cited by 4 publications

(4 citation statements)

References 26 publications

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“…Results of this were comparable to those of Pilkington et al of 95.2%. 17 In this study, the histology was found to be nonrepresentative of the pathology in only nine patients (4.7%). A successful excision biopsy is therefore very useful, especially where there is discordance or indeterminate histology.…”

Section: Successful Localisation Ratesmentioning

confidence: 51%

Radioguided occult lesion localisation: A retrospective audit at a single tertiary academic breast unit

Ismail

Malherbe

Panieri

et al. 2022

South African Journal of Oncology

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Background:The radioguided occult lesion localisation (ROLL) technique was introduced at Groote Schuur Hospital in 2003 replacing the wire-guided localisation (WGL) technique. In the case of preoperative histologically proven impalpable breast cancers, a sentinel lymph node (SLN) biopsy was done simultaneously (sentinel node [SN] with occult lesion localisation or SNOLL).Aim: To assess the efficacy of the ROLL and SNOLL techniques for diagnostic and therapeutic excisions.Setting: A retrospective record analysis of 190 patients who underwent a ROLL procedure for diagnostic or therapeutic excision of occult breast lesions was performed at a large tertiary hospital in the Western Cape.Methods: Data were collected on patient and tumour characteristics, successful localisation rates, the volume of tissue removed, complete tumour resection rates, the number of re-operations performed and the proportion of SLN detection. The Pearson's chi-squared test was used to test for significance between variables at α = 0.05.Results: Correct radiopharmaceutical placement was achieved in 177/190 (93.2%) lesions. Histologic examination of excised specimens confirmed 115/190 (61.0%) malignant and 75/190 (39.0%) benign lesions. Involved margins were found in 37/115 (32.2%). Complete excision with adequate margins occurred in 50/70 (71.4%) of cases of invasive cancer and in 11/45 (24.4%) of ductal carcinoma in situ (DCIS). The SN was successfully identified in 30/37 (81.1%) of SNOLL cases. Conclusion:Radioguided occult lesion localisation is an effective tool in the preoperative localisation of occult lesions for surgical biopsy as well as the removal of impalpable breast cancers. A single intratumoural injection with 99m Tc nanocolloid combined with lymphoscintigraphy is a reliable method of localising the SN. Contribution:The researchers' observations support that the ROLL and SNOLL techniques assessed in this study are practical and reliable procedures to perform.

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Section: Successful Localisation Ratesmentioning

confidence: 51%

Radioguided occult lesion localisation: A retrospective audit at a single tertiary academic breast unit

Ismail

Malherbe

Panieri

et al. 2022

South African Journal of Oncology

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“…While the accuracy of needle and wire placement is important with any means of guidance, it is particularly important for MRI-guided procedures because lesion retrieval cannot be verified with radiography of the lumpectomy specimen, as the lesion is commonly only visible in vivo after the intravenous administration of a gadolinium-based contrast material [9]. Although excisional biopsy after MRI-guided wire localization has proven to be a successful method for obtaining adequate material for pathological evaluation, this technique is associated with several challenges apart from the technical difficulties [10-12], including the accordion effect, which leads to a final wire position that is not the ideal after breast decompression; wire displacement and migration; wire breakage; difficulties related to establishing surgical access to the lesion; infection; and bleeding. Nevertheless, its main disadvantage is the high incidence of residual disease (up to 51% at the biopsy site) [12-15].…”

Section: Introductionmentioning

confidence: 99%

“…Although excisional biopsy after MRI-guided wire localization has proven to be a successful method for obtaining adequate material for pathological evaluation, this technique is associated with several challenges apart from the technical difficulties [10-12], including the accordion effect, which leads to a final wire position that is not the ideal after breast decompression; wire displacement and migration; wire breakage; difficulties related to establishing surgical access to the lesion; infection; and bleeding. Nevertheless, its main disadvantage is the high incidence of residual disease (up to 51% at the biopsy site) [12-15]. …”

Section: Introductionmentioning

confidence: 99%

“…On the day of surgery, a portable gamma probe guides the biopsy, providing a practical and precise method for locating the intratumor injection site. In the last years, this technique has been proposed by many different studies as being the best option for the localization of non-palpable breast lesions guided by mammography or ultrasonography [12,16-19], resulting in correct localization in more than 90% of cases. It has also been associated with a higher prevalence of safe surgical margins, improved cosmetic outcome, and less postoperative pain, in addition to reductions in excision volume and more accurate lesion centricity within the surgical specimen [7,12-20].…”

Section: Introductionmentioning

confidence: 99%

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Magnetic resonance imaging-radioguided occult lesion localization (ROLL) in breast cancer using Tc-99m macro-aggregated albumin and distilled water control

et al. 2013

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BackgroundMagnetic resonance imaging (MRI) guided wire localization presents several challenges apart from the technical difficulties. An alternative to this conventional localization method using a wire is the radio-guided occult lesion localization (ROLL), more related to safe surgical margins and reductions in excision volume. The purpose of this study was to establish a safe and reliable magnetic resonance imaging-radioguided occult lesion localization (MRI-ROLL) technique and to report our initial experience with the localization of nonpalpable breast lesions only observed on MRI.MethodsSixteen women (mean age 53.2 years) with 17 occult breast lesions underwent radio-guided localization in a 1.5-T MR system using a grid-localizing system. All patients had a diagnostic MRI performed prior to the procedure. An intralesional injection of Technetium-99m macro-aggregated albumin followed by distilled water was performed. After the procedure, scintigraphy was obtained. Surgical resection was performed with the help of a gamma detector probe. The lesion histopathology and imaging concordance; the procedure’s positive predictive value (PPV), duration time, complications, and accuracy; and the rate of exactly excised lesions evaluated with MRI six months after the surgery were assessed.ResultsOne lesion in one patient had to be excluded because the radioactive substance came back after the injection, requiring a wire placement. Of the remaining cases, there were four malignant lesions, nine benign lesions, and three high-risk lesions. Surgical histopathology and imaging findings were considered concordant in all benign and high-risk cases. The PPV of MRI-ROLL was greater if the indication for the initial MR examination was active breast cancer. The median procedure duration time was 26 minutes, and all included procedures were defined as accurate. The exact and complete lesion removal was confirmed in all (100%) patients who underwent six-month postoperative MRI (50%).ConclusionsMRI-ROLL offers a precise, technically feasible, safe, and rapid means for performing preoperative MRI localizations in the breast.

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The role of intraoperative ultrasound in breast-conserving surgery of nonpalpable breast cancer

Sikošek

Dovnik

Arko

et al. 2014

Wien Klin Wochenschr

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Impact of radioguided occult lesion localization on the correct excision of malignant breast lesions: effect of histology and tumor size

Cited by 4 publications

References 26 publications

Radioguided occult lesion localisation: A retrospective audit at a single tertiary academic breast unit

Radioguided occult lesion localisation: A retrospective audit at a single tertiary academic breast unit

Magnetic resonance imaging-radioguided occult lesion localization (ROLL) in breast cancer using Tc-99m macro-aggregated albumin and distilled water control

The role of intraoperative ultrasound in breast-conserving surgery of nonpalpable breast cancer

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