Radioguided Occult Lesion Localization Versus Wire-guided Localization of Nonpalpable Breast Lesions: A Comparative Analysis/Nonpalpabl Meme Lezyonlarinda Meme Isaretleme Teli ve Radyoaktif Maddeile Lezyon Lokalizasyonu Yontemlerinin Karsilastirilmasi

• Published in: Journal of academic research in medicine Vol. 10; no. 1; p. 88
• Main Authors: Çolak, Ceylan, Yabul, Fatma Çelik, Kapan, Selin, Koyuncu, Aysel, Inci, Ercan
• Format: Journal Article
• Language: English
• Published: AVES 01.04.2020
• Subjects: Comparative analysis; Diagnostic imaging; Health aspects; Mammography; Medical records; Memes; Surgery; Time; Ultrasound imaging
• ISSN: 2146-6505
• DOI: 10.4274/jarem.galenos.2020.3091

Objective: Wire-guided localization (WGL) is the preoperative localization method most commonly used before the surgical excision of non-palpable breast lesions (NPBLs). Recently, radioguided occult lesion localization (ROLL) has emerged as an alternative to WGL. We sought to compare the efficacy of ROLL with that of WGL for the preoperative localization of NPBLs and to assess our experience encountered as ROLL is implemented at our institution. Methods: We retrospectively identified reports of patients with NPBLs who underwent mammography- or ultrasonography-guided ROLL or WGL between January 2014 and March 2017. Medical records were reviewed to compare radiologic and pathologic findings, rates of accurate localization, specimen volumes, lengths of operation, creation of positive surgical margins, number of simultaneous sentinel lymph node biopsies (SLNB) performed, complication rates, and lengths of hospital stay. Results: Our search identified 67 women (mean age, 52.7 years; range, 32-69 years) diagnosed with NPBLs during the study period. ROLL was used in 25 patients; WGL was used in 42 patients. Both methods had a high accurate localization rate (ROLL, 96%; WGL, 98%). The length of operation was longer in the ROLL group than in the WGL group (p=0.001), and more SLNBs were performed in the ROLL group than in the WGL group. No significant differences were seen between the groups in terms of radiologic and pathologic findings, specimen volumes, positive surgical margins, complication rates, or lengths of hospital stay. Conclusion: ROLL is a promising alternative to WGL for preoperative localization of NPBLs. The operation time for ROLL procedures at our institution will likely decrease as clinicians become more familiar with the procedure. Keywords: Nonpalpable breast lesion, ROLL, WGL Amaç: Telle isaretleme (WGL) non-palpabl meme lezyonlarinin (NPBLs) cerrahi öncesi yerinin belirlenmesinde yaygin olarak kullanilan bir yöntemdir. Son zamanlarda gelistirilen bir teknik olan radyonüklid okült lezyon lokalizasyonu (ROLL) telle isaretlemeye önemli bir alternatiftir. Çalismadaki amacimiz bu iki yöntemi karsilastirmak ve klinigimizde son zamanlarda uygulanmaya baslanan ROLL yöntemi ile ilgili deneyimlerimizi paylasmaktir. Yöntemler: NPBLs olup 2014-2017 yillarinda klinigimizde cerrahi öncesi isaretleme yapilan hastalarin raporlari retrospektif olarak tarandi. Hastalarin medikal kayitlari kontrol edilip, patolojik ve radyolojik bulgulari, dogru lezyon lokalizasyonu, spesmen boyutu, operasyon süresi, cerrahi sinir pozitifigi, simultane sentinel lenf nodu biyopsi sayisi, komplikasyon oranlari, hospitalizasyon süreleri karsilastirildi. Results: NPBLs olan 67 kadin (ortalama yas, 52,7; yas araligi, 32-69) calismaya alindi. ROLL uygulanan 25 hasta ve WGL uygulanan 42 hasta saptandi. Bu iki metodun da dogru lezyon lokalize etme oranlari benzer yükseklikte bulundu (ROLL, 96%; WGL, 98%). ROLL tekniginde operasyon süresi WGL grubuna göre daha uzun sürdü (p=0,001) ve sentinel lenf nod biyopsi sayisinin ROLL grubunda daha fazla oldugu bulundu. Patolojik ve radyolojik bulgular, spesmen boyutu, cerrahi sinir pozitifigi, komplikasyon oranlari, hospitalizasyon süreleri larsilastirildiginda anlamli fark bulunmadi. Sonuç: Non-palpabl meme lezyonlarinda, ROLL ile isaretleme yöntemi ogrenme asamasinda dahi verdigi sonuçlarla telle isaretleme yöntemine alternatif olabilecek umut vaadeden bir yöntemdir. ROLL ile operasyon süresi klinisyenlerin alismasi ile giderek kisalacaktir. Anahtar kelimeler: Non-palpabl meme lezyonu, ROLL, telle isaretleme