Skip to main content

Advertisement

SpringerLink
Log in

Simplified Technique of Radioguided Occult Lesion Localization (ROLL) Plus Sentinel Lymph Node Biopsy (SNOLL) in Breast Carcinoma

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Radioguided occult lesion localization (ROLL) is a new technique to detect nonpalpable breast tumors. We report our experience using injection of a single radiotracer to localize occult lesions together with sentinel lymph node (SLN) biopsy (SNOLL). The aim of this series was to evaluate the feasibility of the technique, its efficacy, and the rate of reoperation.

Methods

Under sonographic guidance, a nanocolloidal tracer was injected peritumorally above and below the lesion. A handheld gamma probe detector was used to locate and to guide its surgical removal. An intraoperative (IO) macroscopic examination of the specimen with margins evaluation and IO imprint cytology of SLN was always performed.

Results

The targeted lesion was localized and removed in all cases. Final pathological diagnosis identified invasive in 70 patients and ductal carcinoma in situ (DCIS) in 2 patients. The average size of the resected lesion was 11 mm (4–50 mm). In 61 out of the 72 patients (85%), the breast specimen had clear and large margins. Sentinel lymph node (SLN) biopsy was performed in 70 patients with an identification rate of 90%. Final pathological SLN metastasis rate approached 25% (pN1 14%, pN1(mi) 11%). Despite intraoperative examination of the specimen, a total of 29% (21 out of 72) patients had to be reoperated (8 patients for involved margins, 10 patients for an involved SLN, and 3 for both).

Conclusion

This technique with a single nanocolloid tracer used both for ROLL and SLN detection is reliable for removing nonpalpable lesions. The use of this technique may have implications for further reducing reoperation rates.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Goedde TA, Frykberg ER, Crump JM, et al. The impact of mammography on breast biopsy. Am Surg 1992; 58:661–6.

    PubMed  CAS  Google Scholar 

  2. Perry NM, EUSOMA Working Party. Quality assurance in the diagnosis of breast disease. EUSOMA Working Party. Eur J Cancer 2001; 37:159–72

    Google Scholar 

  3. Homer MJ. Transection of the localization hooked wire during breast biopsy. AJR Am J Roentgenol 1983; 141:929–30.

    PubMed  CAS  Google Scholar 

  4. Davis PS, Wechsler RJ, Feig SA, et al. Migration of breast biopsy localization wire. AJR Am J Roentgenol 1988;150:787–8.

    PubMed  CAS  Google Scholar 

  5. Chadwick DR, Shorthouse AJ. Wire-directed localization biopsy of the breast: an audit of results and analysis of factors influencing therapeutic value in the treatment of breast cancer. Eur J Surg Oncol 1997; 23:128–33.

    Article  PubMed  CAS  Google Scholar 

  6. Luini A, Zurrida S, Galimberti V, et al. Radioguided surgery of occult breast lesions. Eur J Cancer 1998; 34:204–5.

    Article  PubMed  CAS  Google Scholar 

  7. Monti S, Galimberti V, Trifiro G, et al. Occult breast lesion localization plus sentinel node biopsy (SNOLL): experience with 959 patients at the European Institute of Oncology. Ann Surg Oncol 2007 Aug 1 [Epub ahead of print]

  8. Feggi L, Basaglia E, Corcione S, et al. An original approach in the diagnosis of early breast cancer: use of the same radiopharmaceutical for both non-palpable lesions and sentinel node localisation. Eur J Nucl Med 2001; 28:1589–96.

    Article  PubMed  CAS  Google Scholar 

  9. Ronka R, Krogerus L, Leppanen E, et al. Radio-guided occult lesion localization in patients undergoing breast-conserving surgery and sentinel node biopsy. Am J Surg 2004; 187:491–6.

    Article  PubMed  Google Scholar 

  10. Shimazu K, Tamaki Y, Tagushi T, et al. Lymphoscintigraphic visualization of internal mammary nodes with subdermal injection of radiocolloid in patients with breast cancer. Ann Surg 2003; 237:390–8.

    Article  PubMed  Google Scholar 

  11. De Cicco C, Trifiro G, Intra M, et al. Optimised nuclear medicine method for tumour marking and sentinel node detection in occult primary breast lesions. Eur J Nucl Med Mol I 2004; 31:349–54.

    Article  Google Scholar 

  12. De Cicco C, Cremonesi M, Luini A, et al. Lymphoscintigraphy and radioguided biopsy of the sentinel axillary node in breast cancer. J Nucl Med 1998; 39:2080–4.

    PubMed  Google Scholar 

  13. Nadeem R, Chagla LS, Harris O, et al. Occult breast lesions: a comparison between radioguided occult lesion localisation (ROLL) vs. wire-guided lumpectomy (WGL). Breast 2005; 14:283–9.

    Article  PubMed  CAS  Google Scholar 

  14. Thind CR, Desmond S, Harris O, et al. Radio-guided localization of clinically occult breast lesions (ROLL): a DGH experience. Clin Radiol 2005; 60:681–6.

    Article  PubMed  CAS  Google Scholar 

  15. Luini A, Zurrida S, Paganelli G, et al. Comparison of radioguided excision with wire localization of occult breast lesions. Br J Surg 1999; 86:522–5.

    Article  PubMed  CAS  Google Scholar 

  16. Tanis PJ, Deurloo EE, Valdes Olmos RA, et al. Single intralesional tracer dose for radio-guided excision of clinically occult breast cancer and sentinel node. Ann Surg Oncol 2001; 8:850–5.

    Article  PubMed  CAS  Google Scholar 

  17. Krag D, Weaver D, Ashikaga T, et al. The sentinel node in breast cancer—a multicenter validation study. New Engl J Med 1998; 339:941–6.

    Article  PubMed  CAS  Google Scholar 

  18. Veronesi U, Paganelli G, Galimberti V, et al. Sentinel-node biopsy to avoid axillary dissection in breast cancer with clinically negative lymph-nodes. Lancet 1997; 349:1864–7.

    Article  PubMed  CAS  Google Scholar 

  19. Uren RF, Howman-Giles R, Renwick SB, et al. Lymphatic mapping of the breast: locating the sentinel lymph nodes. World J Surg 2001; 25:789–93.

    Article  PubMed  CAS  Google Scholar 

  20. Cox C, Centeno B, Dickson D, et al. Accuracy of intraoperative imprint cytology for sentinel lymph node evaluation in the treatment of breast carcinoma. Cancer 2005;105:13–20.

    Article  PubMed  Google Scholar 

  21. Chao C, Wong SL, Ackermann D, et al. Utility of intraoperative frozen section analysis of sentinel lymph nodes in breast cancer. Am J Surg 2001; 182:609–15.

    Article  PubMed  CAS  Google Scholar 

  22. Thomas B. Final results of a multi-center clinical trial on an intraoperative, rapid RT-PCR assay for sentinel lymph node metastases in breast cancer patients 5th Biennial international sentinel node society meeting—Sentinel node biopsy: new boundries—(Abstract) 2006:29

  23. Viale G, Dell’Orto P, Mazzarol G, et al. Comparative evaluation of extensive histopathological examination and RT-PCR assays on breast cancer SN. 5th Biennial international sentinel node society meeting—Sentinel node biopsy: new boundries—(Abstract) 2006:43

Download references

Acknowledgements

The authors thank particularly Dr Gabriel Kaufman and Dr Marie-Anne Collignon for their valuable contributions to this article.

Author information

Authors and Affiliations

  1. Department of Gynecologic and Oncologic Surgery, Hôpital Européen Georges Pompidou, 12 Rue Leblanc, 75015, Paris, France

    Vincent Lavoué MD, Claude Nos MD, Marie-Aude Lefrère Belda MD, Anne Ducellier MD & Fabrice Lecuru PhD

  2. L’institut du Sein, Paris Breast Center, 7 Avenue Bugeaud, 75016, Paris, France

    Claude Nos MD, Krishna B. Clough MD & Bruno Poulet MD

  3. Centre Imagerie Médicale de l’Ouest Parisien, 16 Rue Pasteur, 92211, Saint Cloud, France

    Forouhar Baghaie MD & Eric Zerbib MD

Authors
  1. Vincent Lavoué MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Claude Nos MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Krishna B. Clough MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Forouhar Baghaie MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Eric Zerbib MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Bruno Poulet MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Marie-Aude Lefrère Belda MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Anne Ducellier MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Fabrice Lecuru PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Claude Nos MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lavoué, V., Nos, C., Clough, K.B. et al. Simplified Technique of Radioguided Occult Lesion Localization (ROLL) Plus Sentinel Lymph Node Biopsy (SNOLL) in Breast Carcinoma. Ann Surg Oncol 15, 2556–2561 (2008). https://doi.org/10.1245/s10434-008-9994-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-008-9994-y

Keywords

Search

Navigation