Van Esser S, Hobbelink M, Van der Ploeg I M C, Mali W P Th M, Van Diest P J, Borel Rinkes I H M, Van Hillegersberg R
Department of Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands.
J Surg Oncol. 2008 Dec 1;98(7):526-9. doi: 10.1002/jso.21143.
Wire guided localization (WGL) for non-palpable breast cancer is technically difficult and patient unfriendly. Radio guided occult lesion localization (ROLL) takes advantage of the possibility to detect the tumor through the nuclear tracer that is injected directly into the tumor for the sentinel node procedure.
Forty patients with 41 invasive breast carcinomas were treated using ROLL. Patients received a dose of 120 Mbq 99mTc Nanocolloid intra-tumorally on the day of surgery or a dose of 370 Mbq 99mTc Nanocolloïd intra-tumorally the prior day. The sentinel node (SN) was located using patent blue and a gamma ray detection probe that was also employed to guide the tumor excision.
In 31 patients (78%) the invasive tumor was adequately excised. In two cases (5%) a re-excision was required due to inadequately excised carcinoma in situ and in three patients (7.5%) both the invasive and the in situ tumor were inadequately excised. In 35 patients (88%) the SN was found and removed.
The ROLL procedure seems to be an alternative to WGL in patients with non-palpable breast carcinoma. To determine the place of ROLL versus WGL in the treatment of non-palpable breast cancer, a randomized clinical trial is needed.
对于不可触及的乳腺癌，钢丝引导定位（WGL）技术难度大且对患者不友好。放射性引导隐匿性病变定位（ROLL）利用了通过直接注射到肿瘤内用于前哨淋巴结手术的核示踪剂来检测肿瘤的可能性。
对40例患有41例浸润性乳腺癌的患者采用ROLL进行治疗。患者在手术当天瘤内注射120兆贝克勒尔的99mTc纳米胶体，或在前一天瘤内注射370兆贝克勒尔的99mTc纳米胶体。使用专利蓝和伽马射线检测探头定位前哨淋巴结（SN），该探头也用于引导肿瘤切除。
3１例患者（78%）的浸润性肿瘤被充分切除。2例（5%）因原位癌切除不充分需要再次切除，3例（7.5%）浸润性癌和原位癌均切除不充分。35例（88%）患者找到了并切除了前哨淋巴结。
对于不可触及的乳腺癌患者，ROLL手术似乎是WGL 的一种替代方法。为了确定ROLL与WGL在不可触及乳腺癌治疗中的地位，需要进行一项随机临床试验。
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