Sentinel node and occult lesion localization (SNOLL): a systematic review.

Area of Science:

• Oncology
• Surgical Oncology
• Radiology

Background:

• Sentinel node and occult lesion localization (SNOLL) is an alternative to wire-guided localization (WGL).
• It guides surgical excision of non-palpable breast cancer and concurrent sentinel lymph node biopsy (SLNB).
• This review examines SNOLL accuracy in breast-conserving surgery.

Purpose of the Study:

• To review the evidence on the accuracy of SNOLL.
• To evaluate SNOLL's performance in patients undergoing breast-conserving surgery.
• To compare SNOLL with WGL for non-palpable breast cancer localization.

Main Methods:

• Systematic literature search of PubMed, Embase, and Cochrane Library in April 2013.
• Inclusion of studies reporting on tumor-positive margins, re-operation rates, and SLNB performance.
• Focus on non-palpable malignant disease (invasive and in situ) for SNOLL.

Main Results:

• Seven studies involving 983 patients with non-palpable breast cancers were analyzed.
• Complete resection rates ranged from 82% to 90.5%.
• Second operation rates were 2%-12%, SLNB success rates were 88.2%-100%, and failed localization risk was 0%-4.5%.

Conclusions:

• SNOLL is a safe and accurate technique for localizing non-palpable breast cancers.
• Evidence supports SNOLL's efficacy in breast-conserving surgery.
• SNOLL facilitates successful sentinel lymph node biopsy.