Occult Breast Lesion Localization plus Sentinel Node Biopsy (SNOLL): Experience with 959 Patients at the European Institute of Oncology

Monti, Simonetta; Galimberti, Viviana; Trifirò, Giuseppe; Cicco, Concetta De; Peradze, Nicolas; Brenelli, Fabrício; Fernández-Rodrı́guez, Julia; Rotmensz, Nicole; Latronico, Antuono; Berrettini, Anastasio; Mauri, Manuela; Machado, L. S.; Luini, Alberto; Paganelli, Giovanni

doi:10.1245/s10434-007-9452-2

Cited by 82 publications

(65 citation statements)

References 12 publications

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“…The few studies that have been carried out on a greater [3,21]. However, there are no studies in the literature that specifically analyzed the incidence and risk factors for lesion localization failure by ROLL.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Risk Factors of the Intraoperative Localization Failure of Nonpalpable Breast Lesions by Radio‐guided Occult Lesion Localization: A Retrospective Analysis of 579 Cases

Bernardi¹,

Bertozzi

Londero

et al. 2012

World j. surg.

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Section: Discussionmentioning

confidence: 99%

Incidence and Risk Factors of the Intraoperative Localization Failure of Nonpalpable Breast Lesions by Radio‐guided Occult Lesion Localization: A Retrospective Analysis of 579 Cases

Bernardi¹,

Bertozzi

Londero

et al. 2012

World j. surg.

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“…However, the largest two cohort series for RSL and ROLL, [7,8] each comprising nearly 1,000 patients did not suggest the presence of a significant learning curve. This suggests that both techniques are intuitive and the necessary skills easily acquired.…”

mentioning

confidence: 86%

“…However, the clinical relevance of this greater volume of excision remains questionable [6]. The two largest cohort series [7][8][9] each composed of approximately 1,000 patients supports the excellent outcomes achievable with RGL. The economical assessment has also demonstrated no disadvantage for RGL [7,[9][10][11].…”

mentioning

confidence: 94%

“…Errors at any point along this chain can convert a controlled procedure to a potentially dangerous one and result in temporary closure of RSL programmes until resolved [11]. Twenty-nine studies have been published on ROLL [8,12,13, and nine of these studies [8, 12, 23-26, 39, 45, 46] failed to achieve a 100 % intraoperative localization rate, with failure rates being recorded between 0.4 % [8] and 4.5 %, [12] with the figure of 0.4 % being from the largest published series of ROLL with 959 patients [8].…”

mentioning

confidence: 99%

“…It can be demonstrated from what has been presented from the published evidence that it is not possible to identify any differences in clinical outcomes including complications between ROLL and RSL to suggest the superiority of one over the other. Both techniques have proven to be competitively priced in comparison with WGL [7,10,11] and to have no significant learning curves for surgeons [7,8,17,46]. The single area where a difference can be identified currently is in terms of the flexibility and timing of RSL over ROLL.…”

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confidence: 99%

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ROLL versus RSL: toss of a coin?

Ahmed

Douek

2013

Breast Cancer Res Treat

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The safety and benefits of radio-guided localization (RGL) versus wire-guided localization (WGL) surgery in the treatment of non-palpable breast cancers have been confirmed through several meta-analyses. RGL has become the standard of care in several institutions, although overall uptake has been slow. In view of this evidence supporting RGL, we believe that the future discussion is not of RGL versus WGL, but rather of what form of RGL will constitute best practice of care going forward. We therefore discuss the case for radio-guided occult lesion localization versus radioactive seed localization in the treatment of non-palpable breast cancers, is it really a toss of a coin?Keywords Wire-guided localization Á Radio-guided occult lesion localization Á ROLL Á Radioactive seed localization Á RSL Á Radio-guided localization Á Non-palpable breast cancer Non-palpable breast cancers constitute approximately onethird of all diagnosed breast cancers, [1] therefore creating a heavy burden upon health care systems. The current accepted standard of treatment for non-palpable breast cancers of wire-guided localization (WGL) has been increasingly challenged by radio-guided localization (RGL) techniques in the form of radio-guided occult lesion localization (ROLL) and radio-guided seed localization (RSL). In the four meta-analyses of RGL versus WGL, [2][3][4][5] three have demonstrated the superiority of RGL [2,4,5] with the remaining study demonstrating shorter operating times but also greater volume excisions for RGL [3]. However, the clinical relevance of this greater volume of excision remains questionable [6]. The two largest cohort series [7-9] each composed of approximately 1,000 patients supports the excellent outcomes achievable with RGL. The economical assessment has also demonstrated no disadvantage for RGL [7,[9][10][11]. In view of the mounting evidence supporting RGL, the question no longer remains that of the previous decade in terms of deciding between RGL and WGL, but rather the clinically relevant issue has now progressed to deciding between ROLL and RSL in the treatment of non-palpable breast cancers.Both techniques depend upon the presence of a skilled radiologist to perform either ultrasound or stereotactically guided localization, with the administration of between 0.2 and 0.5 mL of 99m Tc-radiolabelled albumin-based colloid for ROLL or a single 8 9 0.4 mm titanium seed radiolabelled with 125 I in RSL. Great variation exists in the radiation dose administered for ROLL, with the literature quoting anywhere between 5 and 123 MBq, [12,13] whilst for RSL it is between 3.7 and 10.7 MBq [14,15]. ROLL requires localization to be performed within 24 h of surgery due to the short 6 h half-life of 99m Tc-labelled colloid and RSL typically is performed 0-5 days prior to surgery [7,[14][15][16][17]. In the primary systemic therapy (PST) setting RSL can be undertaken several months before surgery because the half-life of 125 I is 60 days [18]. This flexibility in the timing of seed insertion provides a clear ...

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Localization of non-palpable breast cancer using a radiolabelled titanium seed

Riet

Jansen

Beek³

et al. 2010

British Journal of Surgery

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Occult Breast Lesion Localization plus Sentinel Node Biopsy (SNOLL): Experience with 959 Patients at the European Institute of Oncology

Abstract: In SNOLL the injection procedures are performed separately, but both lesion and SNs are removed together; axillary dissection is performed if the SN is positive, thus definitive treatment of malignant non-palpable lesions occurs in a single surgical session.

Cited by 82 publications

References 12 publications

Incidence and Risk Factors of the Intraoperative Localization Failure of Nonpalpable Breast Lesions by Radio‐guided Occult Lesion Localization: A Retrospective Analysis of 579 Cases

Incidence and Risk Factors of the Intraoperative Localization Failure of Nonpalpable Breast Lesions by Radio‐guided Occult Lesion Localization: A Retrospective Analysis of 579 Cases

ROLL versus RSL: toss of a coin?

Localization of non-palpable breast cancer using a radiolabelled titanium seed

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