Assessment of ultrasound / radio-guided occult lesion localization in non-palpable breast lesions

Introduction & Aim: Localization techniques of the non-palpable breast lesions remain controversial. Currently the wire guided localization is the standard of care in most countries. Radioisotope for occult lesion localization (ROLL) is a new and simple method without some disadvantage that related to wire like more difficult procedure and chance of wire displacement. We decide to evaluate diagnostic value in localization of non-palpable breast lesions versus conventional procedure in hour patients with ROLL. Methods: In this prospective study, 94 patients with ultrasound detected non-palpable breast lesions, localized by usage of combination ultrasound and radio drug. Under the ultrasonography guidance, 1-10 hours before surgery, 0.1 - 0.2 ml, equivalent to 0.5-1 mCi phytate-Tc-99m was injected into the lesion. Then the lesion localized by a hand-held gamma probe and excided according to radioactivity of lesion. The data were analyzed by SPSS16. Results: Pathologic results were benign in 81.9 % and malignant in 18.1 % of patients. Mean excised tissue volume was 26.29±27 cm³ in all patients. Most patients had a solitary lesion (84.2%), mostly in the left breast (58.9%) and supero-lateral quadrant (41.1%). Mean size of lesions was 15.7 mm in diameter (4-34 mm). There was a need to secondary surgery in 3 patients and inadequate localization in 6 patients without any other complication due to radioisotope injection. Conclusions: Combination usage of ultrasound and radio-guided localization in non-palpable breast lesions is a simple and acceptable method for localization with no significant complications.

Keywords:

ROLL , non- palpable breast lesion localization , radioisotope , breast cancer