Radioguided occult lesion localization (ROLL) versus wire-guided lumpectomy for non-palpable breast lesions: a randomized prospective evaluation.
BACKGROUND
It is important to optimize the localization technique for non-palpable breast lesions.


METHODS
One hundred consecutive women with non-palpable breast lesions were randomized to radioguided occult lesion localization (ROLL) or wire localization (WL). For ROLL technique (99m)Tc-labeled particles of human serum albumin were injected under breast-imaging control. Localization of the lesion was done in the operating room with the aid of a gamma-probe. All lesions were identified in an X-ray control of the surgical specimen. Categorical variables were analyzed with the Chi-square method. Significance was considered at P < 0.05.


RESULTS
All procedures were performed on the same day of excision, on ambulatory basis. Both techniques resulted in 100% retrieval of the lesions. Localization time was reduced with ROLL (P < 0.001). Clear margins were achieved in 88.9% ROLLs and 62.5% WLs (P < 0.05) reducing the requirement of re-excision. There were significant differences in the subjective ease of the procedures in favor of ROLL technique as rated by surgeons and radiologists.


CONCLUSIONS
ROLL technique is as effective as WL for excision of non-palpable breast lesions, reduce localization time and probably the incidence of pathologically involved margins of excision. ROLL appears to improve the learning curve for surgical residents and cosmesis. ROLL is an attractive alternative to WL.
Medina-Franco
Heriberto
H
Department of Surgery, Section of Surgical Oncology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico. herimd@hotmail.com
Abarca-Pérez
Leonardo
L
García-Alvarez
Miriam N
MN
Ulloa-Gómez
José L
JL
Romero-Trejo
Cecilia
C
Sepúlveda-Méndez
Jesús
J
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001706:Biopsy; D001940:Breast / Q000000981:diagnostic imaging*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D004954:Esthetics; D005260:Female; D015902:Gamma Cameras; D006801:Humans; D008327:Mammography; D015412:Mastectomy, Segmental / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D018365:Neoplasm, Residual; D011446:Prospective Studies; D015641:Radiography, Interventional; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin