title: Radioguided occult lesion localisation (ROLL) is available in the UK for impalpable breast lesions.
abstract: BACKGROUND
  To test the feasibility and reliability of ROLL in a district general hospital (DGH) dealing with screening detected breast lesions.
  
  
  METHODS
  [(99m) Tc]-labelled colloidal human serum albumin was injected in the core of the breast lesion under ultrasound or stereotactic guidance 2-4 h prior to surgery. At operation, the radioactivity is localised using a gamma-probe. This allows optimal placement of the skin incision and subsequent WLE of the abnormal area.
  
  
  RESULTS
  ROLL was utilised on 36 patients (median age, 61 years; range, 43-75 years); of these, 33 B5 lesions had a therapeutic one-step procedure (lumpectomy and axillary dissection) and 3 B4 patients had the lesion excised for diagnostic purposes. Localisation lasted a median of 8 min (range, 5-15 min), ROLL-guided wide tumour excision lasted 20 min (range, 15-30 min), and median postoperative hospital stay was 2 days (range, 1-3 days). Median cancer diameter was 12 mm (range, 6-40 mm). Margins were clear in 29 patients, while 7 patients with DCIS had involved margins. Median minimal clearance was 5 mm (range, < 1-10 mm). Patients had either excellent (24/36) or good (12/36) cosmetic results.
  
  
  CONCLUSIONS
  ROLL successfully localised all lesions; this technique can be implemented in any DGH with a Nuclear Medicine Department. The learning curve is short, cost effectiveness is proven, and cosmetic results are highly rewarding. ROLL could rapidly become the standard localisation technique in the UK.
authors.affiliation: Department of Surgery, Whiston Hospital, Prescot, Merseyside, UK. raudisio@doctors.org.uk
authors.forename: Riccardo A
authors.initials: RA
authors.lastname: Audisio
authors.forename: Rana
authors.initials: R
authors.lastname: Nadeem
authors.forename: Olga
authors.initials: O
authors.lastname: Harris
authors.forename: Sean
authors.initials: S
authors.lastname: Desmond
authors.forename: Rani
authors.initials: R
authors.lastname: Thind
authors.forename: Leena S
authors.initials: LS
authors.lastname: Chagla
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D004739:England; D004954:Esthetics; D005240:Feasibility Studies; D005260:Female; D006767:Hospitals, District; D006769:Hospitals, General; D006801:Humans; D015412:Mastectomy, Segmental / Q000379:methods; D008875:Middle Aged; D010173:Palpation; D011300:Preoperative Care / Q000379:methods; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin