Top

World Journal of Surgery

Published in:

01-08-2012

Incidence and Risk Factors of the Intraoperative Localization Failure of Nonpalpable Breast Lesions by Radio-guided Occult Lesion Localization: A Retrospective Analysis of 579 Cases

Authors: Sergio Bernardi, Serena Bertozzi, Ambrogio P. Londero, Giuliana Gentile, Francesco Giacomuzzi, Arnalda Carbone

Published in: World Journal of Surgery | Issue 8/2012

Abstract

Background

The radio-guided occult lesion localization (ROLL) technique allows the identification of nonpalpable breast lesions by means of the preoperative, intratumoral injection of a radiotracer. Our study aimed to determine the incidence and risk factors of ROLL failure.

Methods

We collected data about all women who underwent ROLL in our department from 2002 to 2009, focusing on patient characteristics such as breast size and density, lesion size, localization, histology, radiologist, and surgeon experience. Data were analyzed using R v2.10.1, considering p < 0.05 significant.

Results

A total of 579 ROLLs were performed on 555 women with a mean age of 58.7 (±10.96) years. Incidence of ROLL failure at the first intervention was 4 % (23/579). Through monovariate analysis, ROLL failure was significantly influenced by stereotactic mammography-guided procedure, invasive tumors, pathological and radiological lesion size ≤5 mm, and the lesion’s location in the central or upper breast quadrants. Through multivariate analysis, the most predictive factors for ROLL failure were as follows: lesion localization in the central quadrant, lesion radiological size ≤5 mm, and radiologist inexperience.

Conclusions

The main risk factors for ROLL failure were the radiologist’s inexperience, lesion size ≤5 mm, and its localization in the central subareolar quadrant, probably due to an unfavorable radiological and surgical reaching of the breast area.

Bitencourt AG, Lima EN, Pinto PN, Martins EB, Chojniak R (2009) New applications of radioguided surgery in oncology. Clinics (Sao Paulo) 64(5):397–402CrossRef

Jakub JW, Gray RJ, Degnim AC, Boughey JC, Gardner M, Cox CE (2010) Current status of radioactive seed for localization of nonpalpable breast lesions. Am J Surg 199(4):522–528PubMedCrossRef

De Cicco C, Pizzamiglio M, Trifirò G, Luini A, Ferrari M, Prisco G et al (2002) Radioguided occult lesion localisation (ROLL) and surgical biopsy in breast cancer. Technical aspects. Q J Nucl Med 46(2):145–151PubMed

Chu TY, Lui CY, Hung WK, Kei SK, Choi CLY, Lam HS (2010) Localisation of occult breast lesion: a comparative analysis of hookwire and radioguided procedures. Hong Kong Med J 16(5):367–372PubMed

Mariscal Martínez A, Solà M, de Tudela AP, Julián JF, Fraile M, Vizcaya S et al (2009) Radioguided localization of nonpalpable breast cancer lesions: randomized comparison with wire localization in patients undergoing conservative surgery and sentinel node biopsy. AJR Am J Roentgenol 193(4):1001–1009PubMedCrossRef

Medina-Franco H, Abarca-Pérez L, García-Alvarez MN, Ulloa-Gómez JL, Romero-Trejo C, Sepúlveda-Méndez J (2008) Radioguided occult lesion localization (ROLL) versus wire-guided lumpectomy for non-palpable breast lesions: a randomized prospective evaluation. J Surg Oncol 97(2):108–111PubMedCrossRef

Moreno M, Wiltgen JE, Bodanese B, Schmitt RL, Gutfilen B, da Fonseca LM (2008) Radioguided breast surgery for occult lesion localization–correlation between two methods. J Exp Clin Cancer Res 27:29PubMedCrossRef

Rampaul RS, Bagnall M, Burrell H, Pinder SE, Evans AJ, Macmillan RD (2004) Randomized clinical trial comparing radioisotope occult lesion localization and wire-guided excision for biopsy of occult breast lesions. Br J Surg 91(12):1575–1577PubMedCrossRef

Gray RJ, Salud C, Nguyen K, Dauway E, Friedland J, Berman C et al (2001) Randomized prospective evaluation of a novel technique for biopsy or lumpectomy of nonpalpable breast lesions: radioactive seed versus wire localization. Ann Surg Oncol 8(9):711–715PubMedCrossRef

10.

Akerman G, Tulpin L, de Malartic CM, Morel O, Desfeux P, Barranger E (2009) Radioguided occult lesion localization in breast cancer (ROLL): new techniques? Gynecol Obstet Fertil 37(1):45–49PubMedCrossRef

11.

Pleijhuis RG, Graafland M, de Vries J, Bart J, de Jong JS, van Dam GM (2009) Obtaining adequate surgical margins in breast-conserving therapy for patients with early-stage breast cancer: current modalities and future directions. Ann Surg Oncol 16(10):2717–2730PubMedCrossRef

12.

Sarlos D, Frey LD, Haueisen H, Landmann G, Kots LA, Schaer G (2009) Radioguided occult lesion localization (ROLL) for treatment and diagnosis of malignant and premalignant breast lesions combined with sentinel node biopsy: a prospective clinical trial with 100 patients. Eur J Surg Oncol 35(4):403–408PubMedCrossRef

13.

Bland KI (2008) Editorial on “Radioguided occult lesion localization (ROLL) versus wire-guided lumpectomy for non-palpable breast lesions: a randomized prospective evaluation” by Medina-Franco H et al. J Surg Oncol 97(2):101–102PubMedCrossRef

14.

Medina-Franco H, Abarca-Pérez L, Ulloa-Gómez JL, Romero C (2007) Radioguided localization of clinically occult breast lesions (ROLL): a pilot study. Breast J 13(4):401–405PubMedCrossRef

15.

Lavoué V, Nos C, Clough KB, Baghaie F, Zerbib E, Poulet B et al (2008) Simplified technique of radioguided occult lesion localization (ROLL) plus sentinel lymph node biopsy (SNOLL) in breast carcinoma. Ann Surg Oncol 15(9):2556–2561PubMedCrossRef

16.

Manero MG, Fraile MR, Valero M, Richter JA, López G (2008) New horizons in breast surgery. Radioguided surgery and selective sentinel node biopsy. Rev Med Univ Navarra 52(1):13–17

17.

Barros AC, Barros MA, Andrade FE, Mori LJ, Costa PA, Sheng PY et al (2007) Combined radioguided nonpalpable lesion localization and sentinel lymph node biopsy for early breast carcinoma. Ann Surg Oncol 14(4):1472–1477PubMedCrossRef

18.

Kim J, Chung D, Spillane A (2004) Combined radioguided occult lesion and sentinel node localization for breast cancer. ANZ J Surg 74(7):550–553PubMedCrossRef

19.

Postma EL, Witkamp AJ, van den Bosch MA, Verkooijen HM, van Hillegersberg R (2011) Localization of nonpalpable breast lesions. Expert Rev Anticancer Ther 11(8):1295–1302PubMedCrossRef

20.

Lovrics PJ, Cornacchi SD, Vora R, Goldsmith CH, Kahnamoui K (2011) Systematic review of radioguided surgery for non-palpable breast cancer. Eur J Surg Oncol 37(5):388–397PubMedCrossRef

21.

Monti S, Galimberti V, Trifiro G, Cicco CD, Peradze N, Brenelli F et al (2007) Occult breast lesion localization plus sentinel node biopsy (SNOLL): experience with 959 patients at the European Institute of Oncology. Ann Surg Oncol 14(10):2928–2931PubMedCrossRef

22.

Zurrida S, Galimberti V, Orvieto E, Robertson C, Ballardini B, Cremonesi M et al (2000) Radioguided sentinel node biopsy to avoid axillary dissection in breast cancer. Ann Surg Oncol 7(1):28–31PubMedCrossRef

23.

Giuliano AE, Dale PS, Turner RR, Morton DL, Evans SW, Krasne DL (1995) Improved axillary staging of breast cancer with sentinel lymphadenectomy. Ann Surg 222(3):394–399 discussion 399–401PubMedCrossRef

24.

Krag DN, Meijer SJ, Weaver DL, Loggie BW, Harlow SP, Tanabe KK et al (1995) Minimal-access surgery for staging of malignant melanoma. Arch Surg 130(6):654–658; discussion 659–660PubMedCrossRef

25.

Luini A, Zurrida S, Galimberti V, Paganelli G (1998) Radioguided surgery of occult breast lesions. Eur J Cancer 34(1):204–205PubMedCrossRef

26.

Fasching PA, Heusinger K, Loehberg CR, Wenkel E, Lux MP, Schrauder M et al (2006) Influence of mammographic density on the diagnostic accuracy of tumor size assessment and association with breast cancer tumor characteristics. Eur J Radiol 60(3):398–404PubMedCrossRef

Title: Incidence and Risk Factors of the Intraoperative Localization Failure of Nonpalpable Breast Lesions by Radio-guided Occult Lesion Localization: A Retrospective Analysis of 579 Cases
Authors: Sergio Bernardi
Serena Bertozzi
Ambrogio P. Londero
Giuliana Gentile
Francesco Giacomuzzi
Arnalda Carbone
Publication date: 01-08-2012
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 8/2012
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-012-1577-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Incidence and Risk Factors of the Intraoperative Localization Failure of Nonpalpable Breast Lesions by Radio-guided Occult Lesion Localization: A Retrospective Analysis of 579 Cases

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 8/2012

Effects of Preoperative Oral Carbohydrate Supplementation on Postoperative Metabolic Stress Response of Patients Undergoing Elective Abdominal Surgery

Diagnostic Value of FDG-PET/CT for Lymph Node Metastasis of Colorectal Cancer

Impact of Preoperative α-Fetoprotein Level on Disease-Free Survival After Liver Transplantation for Hepatocellular Carcinoma

Evaluation of Lymph Nodes in Patients with Colon Cancer Undergoing Colon Resection: A Population-based Study

Stapler and Nonstapler Closure of the Pancreatic Remnant After Distal Pancreatectomy: Multicenter Retrospective Analysis of 388 Patients

Surgery, Fame, and Misfortune: The Life of Bronisław Kader