Use of the ROLL technique for lumpectomy in non-palpable breast lesions.
OBJECTIVE
To evaluate the efficiency of radioguided occult lesion localising in non-palpable breast lesions (NPBL) compared to the surgical wire technique.


METHODS
A prospective study was conducted on 161 women with NPBL, of whom 80 marked with the wire (group 1), whereas 81 women were marked with an intratumour injection of99mTc-nanocoloid (group 2). The NPBL were located by ultrasound or stereotactic guidance. The lumpectomies were performed following the wire direction in group 1, and with the aid of a gamma-probe in group 2. Surgical margins were then checked, determining the need of extension if the margin was less than 5mm in the intra-surgical study, and less than 2mm in the deferred study. Data were collected on the mean number detected by surgery, surgical margins, number of extensions, presence of residual tumour in the extension, second surgeries, lumpectomy volume, as well as total resected volume, volume/tumour ratio, and complications.


RESULTS
No significant differences were observed between the two groups in the mean number detected, surgical margins, number of extensions, presence of residual tumour in the extension, second surgeries, lumpectomy volume, total resected volume, volume/tumour ratio or complications. The multivariate analysis showed the determining factors of the resected volume were the radiological guidance technique, as well as the surgeon.


CONCLUSIONS
The radioguided occult lesion localising technique helps in the detection and resection of NPBL with the same efficiency as the surgical wire, and adds the possibility of sentinel node detection in the same surgery. The determining factors of the resected volume were the radiological guidance technique and the surgeon.
Medicina Nuclear, H.U. Joan XXIII, Tarragona, España. Electronic address: david.dcarrera@gmail.com.
D
D
Carrera
Radiología, H.U. Joan XXIII, Tarragona, España.
L
L
Martín
Ginecología, H.U. Joan XXIII, Tarragona, España.
M de la
M
Flor
Cirugía, Hospital Verge de la Cinta, Tortosa, España.
F
F
Guspí
Cirugía, Hospital Sant Pau i Santa Tecla, Tarragona, España.
J
J
Picas
Medicina Nuclear, H.U. Joan XXIII, Tarragona, España.
V
V
Izquierdo
Anatomía Patológica, H.U. Joan XXIII, Tarragona, España.
S
S
Martínez
Cirugía, Hospital Sant Joan de Reus, Reus, España.
C
C
Jordà
Medicina Nuclear, H.U. Joan XXIII, Tarragona, España.
R
R
Siurana
Cirugía, Hospital Pius Valls, Valls, España.
M
M
Martínez-Casals
Anatomía Patológica, Hospital Verge de la Cinta, Tortosa, España.
J M
JM
Jaén
Medicina Nuclear, H.U. Joan XXIII, Tarragona, España.
A
A
Pujol
Medicina Nuclear, H.U. Bellvitge, Hospitalet de LLobtregat, España.
A
A
Benítez
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001941:Breast Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D010173:Palpation; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D025321:Surgery, Computer-Assisted; D013668:Technetium Tc 99m Aggregated Albumin
D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin
Arpón; Breast cancer; Cáncer de mama; ROLL; Surgical wire