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Radioguided Surgery pp 139–148Cite as

Radioguided Surgery of Non-palpable Breast Lesions: Radio Occult Lesion Localization (ROLL)

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Abstract

The incidence of non-palpable breast cancer is rising since national screening programs were introduced. More than 25 % of the radiological suspicious breast lesions are considered clinically occult or non-palpable. Surgical removal of non-palpable breast tumors requires a specific approach. The main challenge of resecting non-palpable lesions is to ensure clear margins while minimizing the resection of healthy tissue and cosmetic damage. Radioguided occult lesion localization (ROLL) using a radioactive tracer (e.g., technetium 99m; half-life of approximately 6 hours) was developed in 1996 and is nowadays used in several institutes as a reliable alternative for wire-guided localization. The commonly used radiotracer is technetium 99m (Tc 99m) macroaggregate albumin (MAA) with a particle size of 10–150 μm, which can be detected by the surgeon using a gamma probe. The tracer is administered by an intratumoral injection, and accordingly, this site is surgically excised at the operating room while using a gamma probe. At the moment more than 29 peer-reviewed articles have emerged about ROLL. The general consensus is that ROLL, using Tc 99m, is preferable over wire-guided localization with the main advantages: the patient comfort, positive margins, and localization time. Furthermore, the procedure can be combined with a sentinel lymph node biopsy.

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Authors and Affiliations

  1. Departement of nuclear medicine, The Netherlands Cancer Institute, Amsterdam, The Netherlands

    Bas Pouw MSc & Renato A. Valdés Olmos MD, PhD

  2. Departement of surgical oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands

    Marie-Jeanne T. F. D. Vrancken Peeters MD, PhD

  3. Leiden University Medical Centre, Leiden, The Netherlands

    Renato A. Valdés Olmos MD, PhD

Authors
  1. Bas Pouw MSc
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  2. Marie-Jeanne T. F. D. Vrancken Peeters MD, PhD
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  3. Renato A. Valdés Olmos MD, PhD
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Correspondence to Bas Pouw MSc .

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Editors and Affiliations

  1. Universitätsklinikum Würzburg, Department of Nuclear Medicine, Würzburg, Germany

    Ken Herrmann

  2. The University of Sydney, Melanoma Institute Australia, North Sydney, New South Wales, Australia

    Omgo E. Nieweg

  3. Arthur G. James Canc Hosp Richard J. Sol, The Ohio State Univ Comp Canc CTR, Columbus, Ohio, USA

    Stephen P. Povoski

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Pouw, B., Peeters, MJ.T.F.D.V., Valdés Olmos, R.A. (2016). Radioguided Surgery of Non-palpable Breast Lesions: Radio Occult Lesion Localization (ROLL). In: Herrmann, K., Nieweg, O., Povoski, S. (eds) Radioguided Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-26051-8_9

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  • DOI: https://doi.org/10.1007/978-3-319-26051-8_9

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