Excision of axillary lymph node recurrences in breast cancer patients with axillary ROLL (A-ROLL).
OBJECTIVE
Conventional surgical exploration to find clinically occult axillary lymph node recurrence of breast cancer can be challenging. The aim of this study was to determine the place of our alternative technique, axillary-ROLL (A-ROLL), in previously treated breast cancer patients with nonpalpable axillary lymph node recurrences.


METHODS
Between March 2005 and May 2009, included in this retrospective study were four women (age, 42-51 years) without clinical evidence of distant metastasis who had treatment for breast cancer and were subsequently found to have suspicious axillary lymph node(s) detected by control ultrasonography (US) examination during follow-up. A-ROLL was utilized for the identification of lymph nodes. 0.5-1 mCi (99m)Tc-human serum albumin makroaggregate was injected under US guidance. A gamma probe was then used to guide the excision of the lymph nodes.


RESULTS
The involved lymph nodes were successfully localized by A-ROLL technique and removed surgically. Of all four patients, postoperative histopathologic examination revealed nodal cancer metastases in three patients (75%) and lymphoid hyperplasia in one patient. No complications occurred.


CONCLUSIONS
A-ROLL technique has proved to be accurate and safe in the identification and excision of clinically occult axillary lymph node recurrence.
Aydogan
Fatih
F
Department of General Surgery, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey.
Ozben
Volkan
V
Atasoy
Deniz
D
Yilmaz
Mehmet Halit
MH
Halaç
Metin
M
Celik
Varol
V
D000328:Adult; D001365:Axilla / Q000601:surgery; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000601:surgery*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*