Strategies for localisation of impalpable breast lesions

With advances in the sensitivity of mammographic screening and the broader population of women screened via national programmes. More than 50% of all new breast cancers in the United Kingdom are screen-detected and of the 11,110 invasive breast cancers (78.7 per cent of all UK cancers) detected in the year 2007-2008, 5814 (52.3 per cent) measured 15 mm or less in diameter and were deemed clinically non-palpable. For excision of non-palpable lesions, localisation techniques are currently largely limited to wire-guided localisation with the associated risks of migration, transection and scheduling conflicts. In this review we will describe the current gold-standard of wire-guided localisation (WGL), its associated merits and limitations before reporting on the data available for Radioguided Occult Lesion Localisation (ROLL) and Radiolabeled Seed Localisation (RSL) trials.