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Non-Palpable Breast Cancer: A Targeting Challenge-Comparison of Radio-Guided vs. Wire-Guided Localization Techniques.

András Drozgyik1,2, Dániel Kollár3, Levente Dankházi4

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|November 27, 2024
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Summary

Radio-guided occult lesion localization (ROLL) and wire-guided localization (WGL) were compared for non-palpable breast cancer. While ROLL offers patient comfort, WGL showed superiority in marking axillary sentinel lymph nodes, especially for inner quadrant tumors.

Keywords:
ROLLbreast cancersentinel lymph node markingwire guided localization

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Area of Science:

  • Oncology
  • Radiology
  • Surgical Techniques

Background:

  • Increasing incidence of non-palpable breast cancer due to enhanced screening and neoadjuvant therapies.
  • Radio-guided occult lesion localization (ROLL) largely supersedes wire-guided localization (WGL) for non-palpable lesions.

Purpose of the Study:

  • To compare the effectiveness of ROLL and WGL in isotopic marking of axillary sentinel lymph nodes.
  • To assess patient perspectives and preferences of surgeons and radiologists regarding these localization techniques.

Main Methods:

  • A single-center, prospective, randomized study involving 110 patients with non-palpable breast lesions (56 ROLL, 54 WGL).
  • Evaluation of breast type, tumor characteristics, and localization/surgical duration.
  • Sentinel lymph node marking utilized technetium-99m-labeled human serum albumin and blue dye.

Main Results:

  • The study included 110 patients, with 56 undergoing ROLL and 54 undergoing WGL.
  • Analysis focused on factors influencing sentinel lymph node marking effectiveness and procedure duration.
  • Statistical significance was defined as p < 0.05, with strong significance at p < 0.01.

Conclusions:

  • ROLL offers benefits in patient comfort and logistical ease.
  • Wire-guided localization (WGL) demonstrated superior performance in axillary sentinel lymph node marking.
  • WGL is particularly advantageous for inner quadrant tumors, suggesting it may be the preferred method in such cases.