Occult breast lesion localization plus sentinel node biopsy (SNOLL): Experience with 959 patients at the European Institute of Oncology

Simonetta Monti, Viviana Galimberti, Giuseppe Trifiro, Concetta DeCicco, Nicolas Peradze, Fabricio Brenelli, Julia Fernandez-Rodriguez, Nicole Rotmensz, Antuono Latronico, Anastasio Berrettini, Manuela Mauri, Leonidas Machado, Alberto Luini, Giovanni Paganelli

Research output: Contribution to journalArticle

Abstract

Background: Non-palpable breast lesions are diagnosed frequently posing the problem of localization and removal. When such lesions are malignant, axillary node status must be determined. We report our experience using radio-guided occult lesion localization (ROLL) for locating and removing non-palpable breast lesions together with sentinel node biopsy (SNB) to assess axillary status. We call the technique SNOLL. Methods: From March 1997 to April 2004, 1046 consecutive patients presented suspicious non-palpable breast lesions and were programmed for conservative surgery and SNB. In 87 patients intraoperative histological examination revealed a benign lesion and SNB was not performed. The remaining 959 patients, with cytologically or histologically proven cancer, underwent SNOLL with immobile radiotracer injected under mammographic or ultrasound (US) guidance into the lesion, and subsequent injection of mobile tracer subdermally to localize the sentinel node (SN). Patients then underwent breast surgery and SNB. Results: Breast lesions were localized by ROLL in 99.6% of cases and were removed radically with negative margins in 91.9% of cases. Sentinel nodes were detected in all but one case. Intraoperative or definitive histological examination revealed 776 invasive/microinvasive carcinomas and 182 with in situ disease. Sentinel nodes were positive in 154 (19.8%) of 776 invasive/microinvasive cancers and in two with ductal intraepithelial neoplasia (1.1%). Conclusions: In SNOLL the injection procedures are performed separately, but both lesion and SNs are removed together; axillary dissection is performed if the SN is positive, thus definitive treatment of malignant non-palpable lesions occurs in a single surgical session.

Original languageEnglish
Pages (from-to)2928-2931
Number of pages4
JournalAnnals of Surgical Oncology
Volume14
Issue number10
DOIs
Publication statusPublished - Oct 2007

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Breast
Biopsy
Radio
Neoplasms
Injections
cyhalothrin
Dissection
Carcinoma

Keywords

  • Breast cancer
  • Occult lesion localization
  • Radiotracer
  • Sentinel node biopsy

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Occult breast lesion localization plus sentinel node biopsy (SNOLL) : Experience with 959 patients at the European Institute of Oncology. / Monti, Simonetta; Galimberti, Viviana; Trifiro, Giuseppe; DeCicco, Concetta; Peradze, Nicolas; Brenelli, Fabricio; Fernandez-Rodriguez, Julia; Rotmensz, Nicole; Latronico, Antuono; Berrettini, Anastasio; Mauri, Manuela; Machado, Leonidas; Luini, Alberto; Paganelli, Giovanni.

In: Annals of Surgical Oncology, Vol. 14, No. 10, 10.2007, p. 2928-2931.

Research output: Contribution to journalArticle

Monti, Simonetta ; Galimberti, Viviana ; Trifiro, Giuseppe ; DeCicco, Concetta ; Peradze, Nicolas ; Brenelli, Fabricio ; Fernandez-Rodriguez, Julia ; Rotmensz, Nicole ; Latronico, Antuono ; Berrettini, Anastasio ; Mauri, Manuela ; Machado, Leonidas ; Luini, Alberto ; Paganelli, Giovanni. / Occult breast lesion localization plus sentinel node biopsy (SNOLL) : Experience with 959 patients at the European Institute of Oncology. In: Annals of Surgical Oncology. 2007 ; Vol. 14, No. 10. pp. 2928-2931.
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abstract = "Background: Non-palpable breast lesions are diagnosed frequently posing the problem of localization and removal. When such lesions are malignant, axillary node status must be determined. We report our experience using radio-guided occult lesion localization (ROLL) for locating and removing non-palpable breast lesions together with sentinel node biopsy (SNB) to assess axillary status. We call the technique SNOLL. Methods: From March 1997 to April 2004, 1046 consecutive patients presented suspicious non-palpable breast lesions and were programmed for conservative surgery and SNB. In 87 patients intraoperative histological examination revealed a benign lesion and SNB was not performed. The remaining 959 patients, with cytologically or histologically proven cancer, underwent SNOLL with immobile radiotracer injected under mammographic or ultrasound (US) guidance into the lesion, and subsequent injection of mobile tracer subdermally to localize the sentinel node (SN). Patients then underwent breast surgery and SNB. Results: Breast lesions were localized by ROLL in 99.6{\%} of cases and were removed radically with negative margins in 91.9{\%} of cases. Sentinel nodes were detected in all but one case. Intraoperative or definitive histological examination revealed 776 invasive/microinvasive carcinomas and 182 with in situ disease. Sentinel nodes were positive in 154 (19.8{\%}) of 776 invasive/microinvasive cancers and in two with ductal intraepithelial neoplasia (1.1{\%}). Conclusions: In SNOLL the injection procedures are performed separately, but both lesion and SNs are removed together; axillary dissection is performed if the SN is positive, thus definitive treatment of malignant non-palpable lesions occurs in a single surgical session.",
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T1 - Occult breast lesion localization plus sentinel node biopsy (SNOLL)

T2 - Experience with 959 patients at the European Institute of Oncology

AU - Monti, Simonetta

AU - Galimberti, Viviana

AU - Trifiro, Giuseppe

AU - DeCicco, Concetta

AU - Peradze, Nicolas

AU - Brenelli, Fabricio

AU - Fernandez-Rodriguez, Julia

AU - Rotmensz, Nicole

AU - Latronico, Antuono

AU - Berrettini, Anastasio

AU - Mauri, Manuela

AU - Machado, Leonidas

AU - Luini, Alberto

AU - Paganelli, Giovanni

PY - 2007/10

Y1 - 2007/10

N2 - Background: Non-palpable breast lesions are diagnosed frequently posing the problem of localization and removal. When such lesions are malignant, axillary node status must be determined. We report our experience using radio-guided occult lesion localization (ROLL) for locating and removing non-palpable breast lesions together with sentinel node biopsy (SNB) to assess axillary status. We call the technique SNOLL. Methods: From March 1997 to April 2004, 1046 consecutive patients presented suspicious non-palpable breast lesions and were programmed for conservative surgery and SNB. In 87 patients intraoperative histological examination revealed a benign lesion and SNB was not performed. The remaining 959 patients, with cytologically or histologically proven cancer, underwent SNOLL with immobile radiotracer injected under mammographic or ultrasound (US) guidance into the lesion, and subsequent injection of mobile tracer subdermally to localize the sentinel node (SN). Patients then underwent breast surgery and SNB. Results: Breast lesions were localized by ROLL in 99.6% of cases and were removed radically with negative margins in 91.9% of cases. Sentinel nodes were detected in all but one case. Intraoperative or definitive histological examination revealed 776 invasive/microinvasive carcinomas and 182 with in situ disease. Sentinel nodes were positive in 154 (19.8%) of 776 invasive/microinvasive cancers and in two with ductal intraepithelial neoplasia (1.1%). Conclusions: In SNOLL the injection procedures are performed separately, but both lesion and SNs are removed together; axillary dissection is performed if the SN is positive, thus definitive treatment of malignant non-palpable lesions occurs in a single surgical session.

AB - Background: Non-palpable breast lesions are diagnosed frequently posing the problem of localization and removal. When such lesions are malignant, axillary node status must be determined. We report our experience using radio-guided occult lesion localization (ROLL) for locating and removing non-palpable breast lesions together with sentinel node biopsy (SNB) to assess axillary status. We call the technique SNOLL. Methods: From March 1997 to April 2004, 1046 consecutive patients presented suspicious non-palpable breast lesions and were programmed for conservative surgery and SNB. In 87 patients intraoperative histological examination revealed a benign lesion and SNB was not performed. The remaining 959 patients, with cytologically or histologically proven cancer, underwent SNOLL with immobile radiotracer injected under mammographic or ultrasound (US) guidance into the lesion, and subsequent injection of mobile tracer subdermally to localize the sentinel node (SN). Patients then underwent breast surgery and SNB. Results: Breast lesions were localized by ROLL in 99.6% of cases and were removed radically with negative margins in 91.9% of cases. Sentinel nodes were detected in all but one case. Intraoperative or definitive histological examination revealed 776 invasive/microinvasive carcinomas and 182 with in situ disease. Sentinel nodes were positive in 154 (19.8%) of 776 invasive/microinvasive cancers and in two with ductal intraepithelial neoplasia (1.1%). Conclusions: In SNOLL the injection procedures are performed separately, but both lesion and SNs are removed together; axillary dissection is performed if the SN is positive, thus definitive treatment of malignant non-palpable lesions occurs in a single surgical session.

KW - Breast cancer

KW - Occult lesion localization

KW - Radiotracer

KW - Sentinel node biopsy

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