Radioguided occult lesion localization plus sentinel node biopsy (SNOLL) versus wire-guided localization plus sentinel node detection: a case control study of 129 unifocal pure invasive non-palpable breast cancers
| Autor: | A. Bourdon, M. Rossi, Gauthier Rathat, P.D. Trinh, P. Taourel, P.-L. Giacalone, M. Sainmont, C. Rouleau, H. Perocchia |
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| Rok vydání: | 2011 |
| Předmět: |
Reoperation
medicine.medical_specialty medicine.medical_treatment Breast Neoplasms Mastectomy Segmental Multimodal Imaging Statistics Nonparametric Biopsy medicine Humans Neoplasm Invasiveness Coloring Agents Retrospective Studies Chi-Square Distribution medicine.diagnostic_test business.industry Sentinel Lymph Node Biopsy Lumpectomy Cancer General Medicine Sentinel node Middle Aged medicine.disease Occult Surgery Oncology Positron emission tomography Case-Control Studies Lymphatic Metastasis Positron-Emission Tomography Technetium Tc 99m Sulfur Colloid Female Radiopharmaceuticals business Nuclear medicine Tomography X-Ray Computed Mastectomy Lymphoscintigraphy Gamma probe |
| Zdroj: | European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 38(3) |
| ISSN: | 1532-2157 |
| Popis: | Aims We compared histological patterns after lumpectomy for non-palpable breast cancers preoperatively localized by radioguided occult lesion localization plus sentinel node localization (SNOLL) versus wire-guided localization. Methods To ensure a homogeneously treated cohort and rigorous comparisons, only patients with invasive cancer and measurable opacity by imaging were included. Exclusion criteria were one or more parameters that could interfere with localization and/or the surgical procedure. Forty-three SNOLL were compared with 86 WGL plus sentinel node (SN) localization. Cancer localization effectiveness was based on careful assessment of histological data from only the first resected glandular specimen, as any additional resection specimens were guided by intraoperative histological examination. Results Reexcisions to ensure free tissue margins were performed during the same procedure in 13.9% of SNOLL versus 31.3% of WGL; p = 0.02. Significantly more women in SNOLL (53.4%) also had free nearest margins of >9 mm after the first procedure compared with WGL (33.7%); p = 0.03. The median centricity ratio after the first procedure was better in SNOLL (2.8, range 1.3–14) than WGL (5, range 1–50); p = 0.008. The median number of SN detected by lymphoscintigraphy was the same in SNOLL and WGL (1, range 0–9, vs. 1, range 0–8). Intraoperative SN detection by blue dye and/or gamma probe was successful for 97.6% of SNOLL versus 93% of WGL. Conclusion In this study, SNOLL was effective and safe, and this procedure significantly improved the rate of negative margins in the first specimen and the rate of reexcision for positive margins compared with WGL. |
| Databáze: | OpenAIRE |
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