ročník 11,2003 č.4

Comparative study of Stereotactic and Radioguided (ROLL) localization of non palpable breast lesions : preliminary results

Santoriello A., Campitiello F., De Bellis W., Cuccurullo V., Sordelli I., Califano U., D.Acunzi D., Mansi L., Canonico S.

Division of General and Geriatric Surgery,
II University of Naples,
Naples, Italy


Advanced imaging techniques and large screening programs are increasing detection of non palpable breast lesions ( size 1-1.5 cm ) that need surgical biopsies, because of early diagnosis of cancer is strictly related to recovery. The preoperative localization of these lesions can be performed using the stereotactic technique or the radioguided localization ( ROLL ).
Both methods present the following purposes : precise localization of the lesion, minimal aesthetic and parenchimal damage, good compliance of the patient, and feasibility in day surgery hospital stay.


We are actually performing a randomised trial to compare ROLL with stereotactic localization of occult breast lesions. In this study 120 patients suffering from non palpable breast lesions have to be enroled, provided with second level diagnostics ( mammography, FNAB, with suspected cancer or non diagnostic cytology. The preliminary results of this study are reported.

Material and methods

Fifty patients treated with stereotactic localization and fifteen patients with radioguided localization of non palpable breast lesions were operated for non palpable breast lesions. All patients underwent operations as day cases under local anaesthesia ( Mepivacaina 1% ) and were discharged 3 to four hours after the operation. The stereotactic technique was realized by a metal hooked wire positioned near the lesion through a Frank needle under ultrasound or mammographic control. The hooked tip of the wire anchors itself in the mammary gland. The surgical biopsy was performed within 24 hours from the positioning. The Radioguided Occult Lesion Localization ( ROLL ) was performed by the injection of Technectium-99m-labeled macrocolloid albumin in the breast nodule localized with ultrasound. The surgeon is guided by an hand-held gamma radiation detector which picks up signals from the radioactivity injected into the lesion or the microcalcifications. This allows removal of the lesion together with an adequate and uniform edges of healthy tissue.


Our preliminary experience suggest that ROLL seems to provide better reperage of the lesion ( 100 % versus 98 %), reducing the amount of healthy tissue removed and the operative time.