Radioguided occult lesion localization versus wire-guided localization for non-palpable breast lesions: randomized controlled trial

• Published in: Clinics (São Paulo, Brazil) Vol. 66; no. 6; pp. 1003 - 1007
• Main Authors: Ocal, Koray, Dag, Ahmet, Turkmenoglu, Ozgur, Gunay, Emel Ceylan, Yucel, Erdem, Duce, Meltem Nass
• Format: Journal Article
• Language: English
• Published: United States Elsevier España, S.L.U 01.01.2011; Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo; Faculdade de Medicina / USP; Elsevier España
• Subjects: Adult; Biopsy - methods; Breast - diagnostic imaging; Breast - pathology; Breast Neoplasms - diagnosis; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Breast Neoplasms, Male - diagnosis; Breast Neoplasms, Male - pathology; Breast Neoplasms, Male - surgery; Chi-Square Distribution; Clinical Science; Female; Fiducial Markers; Humans; Male; MEDICINE, GENERAL & INTERNAL; Middle Aged; Non-palpable breast lesions; Prospective Studies; Radiography, Interventional - methods; Radioguided surgery; Radionuclide Imaging; Radiopharmaceuticals; ROLL technique; Statistics, Nonparametric; Technetium Tc 99m Aggregated Albumin; Time Factors; Treatment Outcome; Wire-guided localization; Radioguided surgery; Non-palpable breast lesions; ROLL technique; Wire-guided localization
• ISSN: 1807-5932; 1980-5322; 1980-5322
• DOI: 10.1590/S1807-59322011000600014

This prospective randomized clinical study was conducted to compare radioguided occult lesion localization (ROLL) with wire-guided localization to evaluate optimum localization techniques for non-palpable breast lesions. A total of 108 patients who were undergoing an excisional biopsy for non-palpable breast lesions requiring pathologic diagnosis were randomly assigned to the ROLL group (n = 56) and wire-guided localization group (n = 52). In the study, patients' characteristics, radiological abnormalities, radiological technique of localization, localization time, operation time, weight of the excised specimen, clearance margins, pathological diagnosis and perioperative complications were assessed. There were no differences between the two groups in terms of age, radiological abnormalities and localization technique (p = non-significant for all). ROLL techniques resulted in 100% retrieval of the lesions; for the wire-guided localization technique, 98%. Both localization time and operation time were significantly reduced with the ROLL technique (p = significant for all). The weight of the specimen was significantly lower in the ROLL group than in the wire-guided localization group (p = significant). The overall complication rate and pathological diagnosis were similar for both groups (p = non-significant for all). Clear margins were achieved in 91% of ROLL patients and in 53% of wire-guided localization patients, and the difference was significant. The present study indicated that the ROLL technique is as effective as wire-guided localization for the excision of non-palpable breast lesions. In addition, ROLL improved the outcomes by reducing localization and operation time, preventing healthy tissue excision and achieving clearer margins.