Several methods have been used for localization of non-palpable breast lesions before excision. The most common method is wire-guided localization which is accompanied by several complications and difficulties for surgeons. Radio-guided localization of non-palpable lesions (ROLL) is a new method which we intended to investigate its diagnostic value for localization of non-palpable breast lesions.
In this study, 42 patients with non-palpable breast lesions, detected by ultrasonography, underwent radio-guided localization. Phytate-Tc-99 m was injected into the lesion under the guide of ultrasonography, 1-2 hours before surgery. Excision of the lesion was performed according to radioactivity signal of lesion, detected by a hand-held gamma probe during surgery. After total excision, the resection bed was explored by gamma probe to detect any remnant lesion. So if there was no radioactivity signal, the incision was closed by the surgeon. The data about ultrasonographic characteristics, localization and excision procedure, complications, margin status and tissue volume were analyzed by SPSS16.
Pathologic results were benign in 90.5% and malignant in 9.5% of patients. Post operative margin of lesion was clear in 100 % of patients. No margin involvement was reported. Mean duration of localization and surgery procedure was 1.80 Â± 0.42 and 26.78 Â± 8.10 minutes. Fault in localization took place in 4 patients (9.5%) and there was a need to secondary surgery in 1 patient (2.4%). Patient's satisfaction level about post operative cosmetic problems was excellent in 33.3% and good in 66.6% of patients. Mean excised tissue volume was 28.59 Â± 27.96 cm3 in all patients and 23.54 Â± 23.46 cm3 in patients with fault of localization.
Radio-guided localization of non-palpable breast lesions is an acceptable method because of technical facilitation, accurate localization and complete excision with clear margin, accompanied by low complications. So it can be recommended as an alternative method for wire-guided localization.
Clinical trial identification
All authors have declared no conflicts of interest.
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