title: Magnetic resonance imaging-guided occult breast lesion localization and simultaneous sentinel lymph node mapping.
abstract: BACKGROUND
  Radio-guided occult lesion localization is a valid technique for the diagnosis of suspicious non-palpable lesions. Here we determine the feasibility of pre-operative localization of occult suspect non-palpable breast lesions using radio-guided occult lesion localization, as well as for identifying the sentinel lymph node.
  
  
  METHODS
  This is a descriptive study of data collected retrospectively. Pre-operative mapping of 34 breast lesions in 25 patients suspected of being malignant was performed using conventional imaging methods with a magnetic resonance imaging-guided radiopharmaceutical injection.
  
  
  RESULTS
  The mean time required to perform the localization was 25 minutes. After resection of the lesions using a gamma probe, malignancy was confirmed in fifteen patients (60.0%), with nine invasive ductal carcinomas, two invasive lobular carcinomas, and four in situ ductal carcinomas The resection was confirmed by the complete removal of the radioactive material. The pathologic results and images were concordant in all but two cases, which were submitted for new magnetic resonance imaging examinations and surgery that confirmed the malignancies. Of the 15 patients with confirmed malignancies, 10 had sentinel lymph node resection. Of these, eight were negative for metastases, one had micro-metastases and one had confirmed metastases. Three patients had full axillary node dissection, with metastases found in only one. No side effects were observed with magnetic resonance-guided radiopharmaceutical injection.
  
  
  CONCLUSIONS
  The sentinel node occult lesion localization technique is a simple, reproducible and effective alternative approach to occult lesions compared to other methods, such as mammotomy and the hook-wire localization technique, for mapping suspect breast lesions and identifying lymph node metastasis.
authors.forename: Marcos Fernando
authors.initials: MF
authors.lastname: de Lima Docema
authors.forename: Paulo Aguirre
authors.initials: PA
authors.lastname: Costa
authors.forename: Felipe Eduardo Martins
authors.initials: FE
authors.lastname: de Andrade
authors.forename: Jose Luiz Barbosa
authors.initials: JL
authors.lastname: Bevilacqua
authors.affiliation: Discipline of Mastology, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Botucatu 740, Vila Clementino, CEP 04023-062, São Paulo, SP, Brazil. simone.elias3@gmail.com.
authors.forename: Simone
authors.initials: S
authors.lastname: Elias
authors.forename: Giovanni Guido
authors.initials: GG
authors.lastname: Cerri
authors.forename: Alfredo Carlos S D
authors.initials: AC
authors.lastname: Barros
authors.forename: Afonso Celso Pinto
authors.initials: AC
authors.lastname: Nazario
mesh_terms: D000328:Adult; D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D018275:Carcinoma, Lobular / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009942:Organometallic Compounds; D011300:Preoperative Care / Q000379:methods*
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C112666:gadoversetamide