Department of Surgical Oncology, Institute of Oncology, Ljubljana, Slovenia.
Breast. 2009 Oct;18(5):294-8. doi: 10.1016/j.breast.2009.08.002. Epub 2009 Sep 5.
Surgical treatment of non-palpable solitary invasive carcinoma consists of localization, tumorectomy and sentinel lymph node biopsy which can successfully be performed with the use of isotopes (SNOLL). The aim of our study was to find out the success rate of SNOLL and the factors that correlated with complete excision of invasive carcinoma. Solitary non-palpable carcinoma was preoperatively diagnosed in 181 cases. After peritumoral injection of nanocolloid labeled with 99mTc under mammographic (N=79) or ultrasound (N=102) guidance, tumorectomy and sentinel node biopsy were performed. Clear surgical margins were obtained in 82% of cases. Surgical margins were likely to be clear (p<0.05) if: (1) the patients were older than 50 years, (2) the weight of surgical specimens >50 g, (3) the tumor radiologic diameter was <or=20 mm, (4) invasive carcinoma was ductal rather than other types of invasive carcinomas. Only one surgical procedure was sufficient for surgical treatment of 75% of cases with non-palpable solitary invasive carcinoma.
术前经乳晕或超声引导下瘤周注射 99mTc 标记的胶体（N=79）或纳米胶体（N=102），对 181 例不可触及的单发浸润性癌行 SNOLL 定位、肿瘤切除术和前哨淋巴结活检。82%的病例获得了切缘阴性。切缘阴性与以下因素显著相关（p<0.05）：（1）患者年龄>50 岁；（2）肿瘤切除标本重量>50g；（3）肿瘤影像学直径≤20mm；（4）浸润性癌为导管癌而非其他类型。75%的不可触及的单发浸润性癌患者仅需一次手术即可完成治疗。
