Department of General Surgery, Medical Faculty, Mersin University, Mersin, Turkey.
Clinics (Sao Paulo). 2011;66(6):1003-7. doi: 10.1590/s1807-59322011000600014.
This prospective randomized clinical study was conducted to compare radioguided occult lesion localization (ROLL) with wire-guided localization to evaluate optimum localization techniques for non-palpable breast lesions.
A total of 108 patients who were undergoing an excisional biopsy for non-palpable breast lesions requiring pathologic diagnosis were randomly assigned to the ROLL group (n = 56) and wire-guided localization group (n = 52). In the study, patients' characteristics, radiological abnormalities, radiological technique of localization, localization time, operation time, weight of the excised specimen, clearance margins, pathological diagnosis and perioperative complications were assessed.
There were no differences between the two groups in terms of age, radiological abnormalities and localization technique (p = non-significant for all). ROLL techniques resulted in 100% retrieval of the lesions; for the wire-guided localization technique, 98%. Both localization time and operation time were significantly reduced with the ROLL technique (p = significant for all). The weight of the specimen was significantly lower in the ROLL group than in the wire-guided localization group (p = significant). The overall complication rate and pathological diagnosis were similar for both groups (p = non-significant for all). Clear margins were achieved in 91% of ROLL patients and in 53% of wire-guided localization patients, and the difference was significant.
The present study indicated that the ROLL technique is as effective as wire-guided localization for the excision of non-palpable breast lesions. In addition, ROLL improved the outcomes by reducing localization and operation time, preventing healthy tissue excision and achieving clearer margins.
本前瞻性随机临床试验旨在比较放射性示踪隐匿性病灶定位（ROLL）与导丝引导定位，以评估非触诊性乳腺病变的最佳定位技术。
共纳入 108 例因非触诊性乳腺病变需行病理诊断而行切除术的患者，随机分为 ROLL 组（n = 56）和导丝引导定位组（n = 52）。在该研究中，评估了患者的特征、影像学异常、定位技术、定位时间、手术时间、切除标本重量、切缘状态、病理诊断和围手术期并发症。
两组在年龄、影像学异常和定位技术方面无差异（p 值均非显著）。ROLL 技术可 100%检出病灶，导丝引导定位技术则为 98%。ROLL 技术可显著缩短定位时间和手术时间（p 值均显著）。ROLL 组切除标本重量显著低于导丝引导定位组（p 值显著）。两组总体并发症发生率和病理诊断相似（p 值均非显著）。ROLL 组的切缘状态达到 91%，导丝引导定位组为 53%，差异显著。
本研究表明，对于非触诊性乳腺病变的切除，ROLL 技术与导丝引导定位同样有效。此外，ROLL 技术通过缩短定位和手术时间、避免健康组织切除和获得更清晰的切缘，改善了手术结果。
