Medina-Franco Heriberto, Abarca-Pérez Leonardo, Ulloa-Gómez José L, Romero Cecilia
Department of Surgery, Section of Surgical Oncology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico.
Breast J. 2007 Jul-Aug;13(4):401-5. doi: 10.1111/j.1524-4741.2007.00448.x.
Management of nonpalpable breast lesions requiring pathologic diagnosis has been with wire localization during the last few decades. Recently, radioguided localization (ROLL) became an alternative for this type of lesions. The objective of the present study was to evaluate the feasibility of this technique in a tertiary referral center in Mexico City. Consecutive patients requiring pathologic diagnosis from a nonpalpable breast lesion were included in the present study. On the same day of operation, all patients were injected with particles of human serum albumin. Localization of the lesion was performed in the operation theater with the aid of a hand-held gamma-probe. All lesions were identified in a control x-ray of the surgical specimen. Demographic, clinical, surgical and pathologic data were recorded. Forty patients with a mean age of 56.8 +/- 7.8 years were included. In 39 of the 40 patients (97.5%) the "hot spot" was identified easily. In all patients, the area of maximum radioactivity corresponded to the site of the lesion. Imaging confirmation of the lesion in the surgical specimen was done during the first excision in 37 patients (92.5%). In the remaining cases (7.5%), a wider excision was performed during the same procedure, finding the suspected lesion in all cases. Diagnosis of cancer was made in seven patients, (17.5%). There were no significant surgical complications. Our data suggest that ROLL offer a simple and reliable method to localize occult breast lesions, allowing complete removal of the lesion in 100% of the patients. Because of the small quantity of radioactivity, the procedure is safe for both patients and the medical staff, producing less discomfort in patients than wire localization.
在过去几十年里，对于需要病理诊断的不可触及乳腺病变，一直采用金属丝定位法进行处理。最近，放射性引导定位（ROLL）成为了这类病变的一种替代方法。本研究的目的是评估该技术在墨西哥城一家三级转诊中心的可行性。本研究纳入了因不可触及乳腺病变需要病理诊断的连续患者。在手术当天，所有患者均注射了人血清白蛋白颗粒。在手术室借助手持γ探测器对病变进行定位。所有病变在手术标本的对照X光片中均被识别出来。记录了人口统计学、临床、手术和病理数据。纳入了40例平均年龄为56.8±7.8岁的患者。在40例患者中的39例（97.5%）中，“热点”很容易被识别出来。在所有患者中，最大放射性区域与病变部位相对应。37例患者（92.5%）在首次切除时对手术标本中的病变进行了影像确认。在其余病例（7.5%）中，在同一手术过程中进行了更广泛的切除，所有病例均发现了疑似病变。7例患者（17.5%）被诊断为癌症。没有明显的手术并发症。我们的数据表明，ROLL提供了一种简单可靠的方法来定位隐匿性乳腺病变，能使100%的患者完全切除病变。由于放射性剂量小，该操作对患者和医护人员都是安全的，与金属丝定位相比，给患者带来的不适更少。
