[US-guided localization of non-palpable breast cancer and sentinel node using 99mTechnetium-albumin colloid]

Surgery on non-palpable breast lesions is becoming increasingly common and new techniques for preoperative lesion localization have appeared. Radio-guided occult lesion localization (ROLL) enables malignant or probably malignant non-palpable breast lesions to be located and biopsy of the sentinel node to be performed (SNOLL: sentinel node and occult lesion localization).

Included were 118 patients with malignant or probably malignant non-palpable breast lesions visible on ultrasonography in whom radio-guided lesion resection and sentinel node biopsy were indicated. 99mTechnetium-albumin colloid was injected into the periphery of the lesion under ultrasonographic guidance and all patients underwent preoperative scintigraphy.

From November 2001 to December 2004, 118 patients were included. All patients underwent conservative surgery, with the non-palpable lesion being located in all cases (100% lesion detection rate). The histological diagnoses were: 81 invasive ductal carcinomas (68.64%), 7 infiltrating lobular carcinomas (5.93%), 5 mixed-type carcinomas (4.24%), 17 carcinomas in situ (14.40%), and 8 other invasive carcinomas (6.78%). The sentinel node was detected in 98.41%.

Radio-guided ROLL surgery on non-palpable lesions located under ultrasonographic guidance is a simple, fast technique that enables the lesion to be safely excised. Both ROLL and SNOLL can be carried out in the same intervention with a single ultrasound-guided injection of 99mTechnetium-albumin colloid with satisfactory results.