Patient satisfaction with Radioguided Occult Lesion Localisation using iodine-125 seeds (‘ROLLIS’) versus conventional hookwire localisation

Ong, Jeremy; Teh, Joelin; Saunders, Christobel; Bourke, Anita G.; Lizama, Catalina; Newton, Jade C.; Phillips, Michael; Taylor, Donna

doi:10.1016/j.ejso.2017.09.021

Cited by 21 publications

(21 citation statements)

References 29 publications

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“…Preoperative hookwire localization is an essential tool in the surgical management of non-palpable breast lesions, especially suspicious microcalcifications [ 42 ]. It is generally performed under 2D mammography guidance at the discretion of the radiologist.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Performance of Digital Breast Tomosynthesis for Breast Suspicious Calcifications From Various Populations: A Comparison With Full-field Digital Mammography

Zhang

Jiang

et al. 2019

Computational and Structural Biotechnology Journal

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The diagnostic performance difference between digital breast tomosynthesis (DBT) and conventional full-field digital mammography (FFDM) for breast suspicious calcifications from various populations is unclear. The objective of this study is to determine whether DBT exhibits the diagnostic advantage for breast suspicious calcifications from various populations compared with FFDM. Three hundred and five patients were enrolled (of which seven patients with bilateral lesions) and 312 breasts images were retrospectively analyzed by three radiologists independently. The postoperative pathology of breast calcifications was the gold standard. Breast cancer was diagnosed utilizing DBT and FFDM with sensitivities of 92.9% and 88.8%, specificities of 87.9% and 75.2%, positive predictive values of 77.8% and 62.1%, negative predictive values of 96.4% and 93.6%, respectively. DBT exhibited significantly higher diagnostic accuracy for benign calcifications compared with FFDM (87.9% vs 75.2%), and no advantage in the diagnosis of malignant calcifications. DBT diagnostic accuracy was notably higher than FFDM in premenopausal (88.4% vs 78.8%), postmenopausal (90.2% vs 77.2%), and dense breast cases (89.4% vs 81.9%). There was no significant difference in non-dense breast cases. In our study, DBT exhibited a superior advantage in dense breasts and benign calcifications cases compared to FFDM, while no advantage was observed in non-dense breasts or malignant calcifications cases. Thus, in the breast cancer screening for young women with dense breasts, DBT may be recommended for accurate diagnosis. Our findings may assist the clinicians in applying the optimal techniques for different patients and provide a theoretical basis for the update of breast cancer screening guideline.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Performance of Digital Breast Tomosynthesis for Breast Suspicious Calcifications From Various Populations: A Comparison With Full-field Digital Mammography

Zhang

Jiang

et al. 2019

Computational and Structural Biotechnology Journal

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“…However, it requires more complex logistical planning because the hookwire must be placed at the same day of surgery, while ROLL-node injections or iodine-125 seed placement can be scheduled on the day before surgery. Further, hookwire localization is associated with more stress and discomfort for patients in comparison to iodine-125 seed localization and has the risk of dislocation [22]. Finally, intraoperative ultrasound can be used to guide the surgeon in locating the clip-marked node [23].…”

Section: Discussionmentioning

confidence: 99%

Feasibility of radioguided occult lesion localization of clip-marked lymph nodes for tailored axillary treatment in breast cancer patients treated with neoadjuvant systemic therapy

et al. 2019

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BackgroundSelective removal of initially tumor-positive axillary lymph nodes in breast cancer patients who underwent neoadjuvant systemic treatment (NST) improves the accuracy of nodal staging and provides the opportunity for more tailored axillary treatment. This study evaluated whether radioguided occult lesion localization (ROLL) of clip-marked lymph nodes is feasible in clinical practice.MethodsPrior to NST, a clip marker was placed inside a proven tumor-positive lymph node in all breast cancer patients (cTis-4N1-3 M0). After NST, technetium-99m-labeled macroaggregated albumin was injected in the clip-marked lymph nodes. The next day, these ROLL-marked nodes were selectively removed at surgery to evaluate the pathological response of the axilla.ResultsThirty-seven patients (38 axillae) underwent clip insertion. After NST, the clip was visible by ultrasound in 36 procedures (95%). In the other two patients, the ROLL-node injection was performed in a sonographically suspicious unclipped node (1), and near the clip under computed tomography guidance (1). Initial surgery successfully identified the ROLL-marked node with clip in 33 procedures (87%). Removed specimens in the other five procedures contained only the sonographically suspicious tumor-positive unclipped node (1), a node with signs of complete response but no clip (2), a clip without node (1), and tissue without node nor clip, and a second successful ROLL-node procedure was performed (1). Overall, 10 ROLL-marked nodes had no residual disease.ConclusionsThis study demonstrates that the ROLL procedure to identify clip-marked lymph nodes is feasible. This facilitates selective removal at surgery and may tailor axillary treatment in patients treated with NST.

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“…) as close as possible to the centre of the target lesion or immediately adjacent to the marker clip. Pre‐loaded needle kits (Advantage‐Load) were used, and the seed deployed by fully advancing a stylet within the needle. The seed (and lesion) was then localised in theatre with the use of a hand‐held gamma probe and excised .…”

Section: Methodsmentioning

confidence: 99%

“…The approach taken for localisation, either CC or lateral, was at the discretion of the performing radiologist . The aim was to traverse the shortest skin to lesion distance possible with the wire wherever possible . The image that most clearly depicted the calcifications, mass, architectural distortion or marker clip was selected, and a crosshair placed on the target .…”

Section: Methodsmentioning

confidence: 99%

A comparison of stereotactic and tomosynthesis‐guided localisation of impalpable breast lesions

Madeley

Kessell

Madeley³

et al. 2019

J of Medical Radiation Sci

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Introduction Impalpable breast cancers require precise pre‐operative lesion localisation to minimise re‐excision rates. Conventional techniques include hookwire insertion using stereotactic guidance. Newer techniques include the use of tomosynthesis guidance and the use of iodine‐125 seeds. This study compares the accuracy of lesion localisation with hookwire or seed insertion using prone stereotactic or upright tomosynthesis guidance. Methods This registered quality improvement activity did not require formal ethics approval. The post‐localisation images for 116 lesions were reviewed. The distance from the lesion or breast biopsy marker to the hookwire or seed was measured on post‐insertion mammograms. The relative placement accuracy of hookwire or seed using prone stereotactic or upright tomosynthesis guidance was compared. A lesion to seed or wire distance > 10 mm was considered technically unsatisfactory. Results 94.8% of the seeds and wires inserted via prone stereotactic guidance were accurately placed, compared with 89.6% of those inserted via upright tomosynthesis. There were twice as many technically unsatisfactory insertions under upright tomosynthesis guidance. The majority of the unsatisfactory insertions using upright tomosynthesis occurred when the lesion was at or below the level of the nipple and the insertion was performed craniocaudally. Conclusion The degree of accuracy of pre‐operative localisation of impalpable breast lesions is significantly higher with the use of prone stereotactic rather than upright tomosynthesis guidance. This was most evident with the placement of I‐125 seeds, and in cases where the target lesion was located below the level of the nipple.

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Patient satisfaction with Radioguided Occult Lesion Localisation using iodine-125 seeds (‘ROLLIS’) versus conventional hookwire localisation

Cited by 21 publications

References 29 publications

Diagnostic Performance of Digital Breast Tomosynthesis for Breast Suspicious Calcifications From Various Populations: A Comparison With Full-field Digital Mammography

Diagnostic Performance of Digital Breast Tomosynthesis for Breast Suspicious Calcifications From Various Populations: A Comparison With Full-field Digital Mammography

Feasibility of radioguided occult lesion localization of clip-marked lymph nodes for tailored axillary treatment in breast cancer patients treated with neoadjuvant systemic therapy

A comparison of stereotactic and tomosynthesis‐guided localisation of impalpable breast lesions

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