Article: article from journal or magazin.
Radioguided occult lesion localization plus sentinel node biopsy (SNOLL) versus wire-guided localization plus sentinel node detection: a case control study of 129 unifocal pure invasive non-palpable breast cancers.
European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
AIMS: We compared histological patterns after lumpectomy for non-palpable breast cancers preoperatively localized by radioguided occult lesion localization plus sentinel node localization (SNOLL) versus wire-guided localization.¦METHODS: To ensure a homogeneously treated cohort and rigorous comparisons, only patients with invasive cancer and measurable opacity by imaging were included. Exclusion criteria were one or more parameters that could interfere with localization and/or the surgical procedure. Forty-three SNOLL were compared with 86 WGL plus sentinel node (SN) localization. Cancer localization effectiveness was based on careful assessment of histological data from only the first resected glandular specimen, as any additional resection specimens were guided by intraoperative histological examination.¦RESULTS: Reexcisions to ensure free tissue margins were performed during the same procedure in 13.9% of SNOLL versus 31.3% of WGL; p = 0.02. Significantly more women in SNOLL (53.4%) also had free nearest margins of >9 mm after the first procedure compared with WGL (33.7%); p = 0.03. The median centricity ratio after the first procedure was better in SNOLL (2.8, range 1.3-14) than WGL (5, range 1-50); p = 0.008. The median number of SN detected by lymphoscintigraphy was the same in SNOLL and WGL (1, range 0-9, vs. 1, range 0-8). Intraoperative SN detection by blue dye and/or gamma probe was successful for 97.6% of SNOLL versus 93% of WGL.¦CONCLUSION: In this study, SNOLL was effective and safe, and this procedure significantly improved the rate of negative margins in the first specimen and the rate of reexcision for positive margins compared with WGL.
Breast Neoplasms/pathology, Breast Neoplasms/radionuclide imaging, Case-Control Studies, Chi-Square Distribution, Coloring Agents/diagnostic use, Female, Humans, Lymphatic Metastasis/pathology, Lymphatic Metastasis/radionuclide imaging, Lymphoscintigraphy, Mastectomy, Segmental, Middle Aged, Neoplasm Invasiveness, Positron-Emission Tomography and Computed Tomography, Radiopharmaceuticals/diagnostic use, Reoperation, Retrospective Studies, Sentinel Lymph Node Biopsy, Statistics, Nonparametric, Technetium Tc 99m Sulfur Colloid/diagnostic use
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