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. 2018 Winter;6(1):10-14.
doi: 10.22038/aojnmb.2017.9898.

Assessment of Ultrasound / Radio-guided Occult Lesion Localization in Non-palpable Breast Lesions

Seyed Ali Alamdaran  1 , Donia Farokh  2 , Ayda Sharifi Haddad  2 , Navid Daghighi  2 , Elaheh Modoodi  2 , Ramin Sadeghi  3 , Mohammad Naser Forghani  1 , Asieh Sadat Fattahi  4
Affiliations

Assessment of Ultrasound / Radio-guided Occult Lesion Localization in Non-palpable Breast Lesions

Seyed Ali Alamdaran et al. Asia Ocean J Nucl Med Biol. 2018 Winter.

Abstract

Objectives: Controversy exists about the localization of non-palpable breast lesions. In many countries, the gold standard for the diagnosis of these lesions is needle localization due to its accuracy. This study sought to compare the ultrasound- and radio-guided occult lesion localization (ROLL) as a simple method with the conventional procedures in terms of their diagnostic power.

Methods: This study was conducted on 94 patients with non-palpable breast lesions detected by ultrasonography and localized by the combination of ultrasonography and using radiopharmaceuticals. One to ten hours prior to surgery, 0.1-0.2 ml (equivalent to 0.5-1 mCi) of Tc-99m-phytate was injected to the lesion under the guidance of ultrasonography. Then, the lesion was localized using a hand-held gamma probe, and excision of the lesion was performed according to its radioactivity signal. Data analysis was performed using SPSS, version 16.

Results: Benign and malignant pathologic results were observed in 77 (81.9%) and 17(18.1%) of the patients, respectively, and the mean volume of the excised tissue was 26.29±27 mm³. 79 patients had a solitary lesion (84%), 55 in the left breast (58.5%) and 39 in superolateral quadrant (41.5%). The mean size of the lesions was 15.7 mm in diameter (ranging from 4 to 34 mm). Additionally, there was a need to secondary surgery in 3 (3.2%) patients and inappropriate localization in 6 (6.4%) patients (subcutaneous or intra-ductal spread of radiodrug).

Conclusion: Combination of ultrasound- and radio-guided localization methods for localizing non-palpable breast lesions is a simple and acceptable method for localization with no significant complications. For radio-drug spread and subsequent excessive excised tissue volume, subcutaneous and intra-ductal lesions are not suitable indication for ROLL.

Keywords: Non-palpable breast lesion localization; ROLL; Radiopharmaceuticals; Ultrasound.

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