Procedures for location of non-palpable breast lesions: a systematic review for the radiologist

Abstract

Accurate location of small breast lesions is mandatory for proper surgical management. The purpose of this article is systematically review procedures used to locate non-palpable breast lesions, including a description of the current status, advantages, and disadvantages for each technique. A total of 47 articles were finally included: 7 articles for the wire location technique, 5 articles for the radioguided location technique, 13 articles that compare wire location with radioguided location, 3 articles for the carbon location technique, 2 articles that compare wire location with carbon location, and 17 articles for the clip location technique. The success of location and the clear margin are reported for each location technique and for the separate articles included; clip migration shift, also, is reported for the clip location technique. Odds ratio with related 95 % confidence intervals were also calculated for successful location. Comparative analysis or meta-analysis for all the different breast lesion location techniques is missing. Prospective investigations and randomized investigations for homogeneous populations are still needed to determine which is the most cost-effective modality among those used to date.

Proteomic profile of saliva and plasma from women with impalpable breast lesions

“…The detection of impalpable breast lesions by mammography has become more common, accounting for ~25% of diagnosed breast pathologies (1). The detection of impalpable breast lesions generates questions associated with the nature of the lesion (benign or malignant) and, consequently, with the conduct of the investigation to be executed.…”

Heading toward radioactive seed localization in non-palpable breast cancer surgery? A meta-analysis

“…Dislodging and poor localization are causes for relatively high irradicality rates for WGL ranging from 10% to 50% [4,8,[16][17][18][19][20][21][22][23]. Radioguided occult lesion localization (ROLL) was developed in 1996, and is nowadays used in several institutes as a reliable alternative for WGL [5,20,[24][25][26][27][28][29]. The principle of this technique consists of an image (frequently ultrasound and stereotaxis) guided intratumoral injection of a radioactive tracer (most commonly used is Technetium-99m ( 99m Tc) macro-aggregate albumin), which is retained within the tumor and can be detected by the surgeon using a gamma probe.…”

Breast localization techniques and margin definitions used by Australian and New Zealand surgeons

“…It was anticipated that a GSSE short course would improve participants' success in passing the GSSE, although there are few published studies on the success of courses with similar objectives. [1][2][3][4][5]…”

“…For an overview of LLTs, the reader is referred to the following articles. 3,4 Optimal BCS aims for negative margins with minimal removal of normal tissue, both of which are influenced by LLT. Studies have reported poor lesion centring within the excised tissue, with involvement of margins, and excessive tissue removal at others.…”