20– 22 Because most of these studies are non-randomized and included a limited patient number, we present a prospective randomized study comparing ROLL with WGL for non-palpable breast lesions. However, although ROLL has been used for more than 10 years, there are a small number of reports in the literature investigating the superiority between ROLL and WGL. 16– 19 In addition, in recent studies investigating the feasibility of ROLL for lesion localization, the method was shown to be a simple, fast and accurate technique. During the last decade, ROLL has gained popularity on account of several advantages associated with a reduced excision volume, more accurate centricity of a lesion within the surgical specimen, better cosmetic results and a higher percentage of tumor-free margins. Radioactivity allows for the radiolabeling of the lesion and subsequent surgical excision guided by a handheld gamma ray detection probe. 13– 15 The approach involves the intratumoral injection of a small amount of nuclear radiotracer under guidance by ultrasonography or stereotactic mammography. Radioguided occult lesion localization (ROLL) is a new method for the localization and resection of non-palpable breast lesions. Furthermore, migration or rupture of the wire leads to a small risk of pneumothorax, and the discomfort of the patient and injuries for both the surgical team and the pathologist are other restrictions of the procedure. For surgical excision with free margins, the surgeon must follow the wire through healthy tissue until the lesion is found, and this causes the extensive removal of healthy breast tissue. 9 The wire may be displaced during surgery. The placement of the wire is difficult in dense breast tissue. Although WGL has been shown to accurately localize the lesions, the technique has some disadvantages. 6– 8 However, the ideal technique should involve precise localization, avoid the excessive surgical resection of healthy breast tissue, improve the rate of free margin, not discomfort the patient and decrease operative time. Wire-guided localization (WGL) is presently the most commonly used localization method for non-palpable breast lesions. 4, 5 Several techniques have been developed as a diagnostic and therapeutic tool. 1– 3 Some 15–20% of these lesions are malignant, and their removal should be preceded by a radiographically guided localization procedure to assure an accurate and low tissue volume biopsy. Suspicious clinically occult breast lesions are found frequently as a result of widespread mammographic screening programs of asymptomatic women.
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