ABSTRACT
OBJECTIVE: Surgery on non-palpable breast lesions is becoming increasingly common and new techniques for preoperative lesion localization have appeared. Radio-guided occult lesion localization (ROLL) enables malignant or probably malignant non-palpable breast lesions to be located and biopsy of the sentinel node to be performed (SNOLL: sentinel node and occult lesion localization). MATERIAL AND METHODS: Included were 118 patients with malignant or probably malignant non-palpable breast lesions visible on ultrasonography in whom radio-guided lesion resection and sentinel node biopsy were indicated. 99mTechnetium-albumin colloid was injected into the periphery of the lesion under ultrasonographic guidance and all patients underwent preoperative scintigraphy. RESULTS: From November 2001 to December 2004, 118 patients were included. All patients underwent conservative surgery, with the non-palpable lesion being located in all cases (100% lesion detection rate). The histological diagnoses were: 81 invasive ductal carcinomas (68.64%), 7 infiltrating lobular carcinomas (5.93%), 5 mixed-type carcinomas (4.24%), 17 carcinomas in situ (14.40%), and 8 other invasive carcinomas (6.78%). The sentinel node was detected in 98.41%. DISCUSSION AND CONCLUSIONS: Radio-guided ROLL surgery on non-palpable lesions located under ultrasonographic guidance is a simple, fast technique that enables the lesion to be safely excised. Both ROLL and SNOLL can be carried out in the same intervention with a single ultrasound-guided injection of 99mTechnetium-albumin colloid with satisfactory results.
Subject(s)
Breast Neoplasms/diagnostic imaging , Radiopharmaceuticals , Technetium Tc 99m Aggregated Albumin , Adult , Aged , Breast Neoplasms/pathology , Female , Humans , Middle Aged , Radionuclide Imaging , Sentinel Lymph Node Biopsy , UltrasonographyABSTRACT
Objetivo. La cirugía de lesiones no palpables de mama va en aumento y han aparecido nuevas técnicas de localización preoperatoria. La técnica ecodirigida denominada ROLL (radioguided occult lesion localisation) permite localizar las lesiones de mama no palpables malignas o probablemente malignas y la biopsia del ganglio centinela (sentinel node and occult lesion localisation [SNOLL]).Material y métodos. Se incluyen 118 pacientes con lesiones de mama no palpables malignas o probablemente malignas visibles con ecografía, en las que está indicada la exéresis radioguiada de la lesión y la biopsia del ganglio centinela. Se inyecta con control ecográfico 99mtecnecio- coloide de albúmina en la periferia de la lesión y se realiza gammagrafía preoperatoria en todos los casos.Resultados. Desde noviembre del 2001 hasta diciembre del 2004 se incluyen 118 pacientes. En todas se realiza cirugía conservadora, localizando la lesión no palpable en todos los casos (tasa de detección de la lesión del 100%). El resultado anatomopatológico es: 81 carcinomas ductales infiltrantes (68,64%), 7 carcinomas lobulillares infiltrantes (5,93%), 5 carcinomas mixtos (4,24%), 17 carcinomas in situ (14,40%) y 8 otros carcinomas infiltrantes (6,78%). La detección del ganglio centinela es posible en un 98,41%.Discusión y conclusiones. La cirugía radioguiada ROLL de lesiones no palpables de mama localizadas con control ecográfico es una técnica sencilla y rápida que permite la exéresis de la lesión con seguridad. Se pueden realizar tanto ROLL como SNOLL en la misma intervención con una única inyección ecodirigida de 99mtecnecio-coloide de albúmina con resultados satisfactorios
Objective. Surgery on non-palpable breast lesions is becoming increasingly common and new techniques for preoperative lesion localization have appeared. Radio-guided occult lesion localization (ROLL) enables malignant or probably malignant non-palpable breast lesions to be located and biopsy of the sentinel node to be performed (SNOLL: sentinel node and occult lesion localization).Material and methods. Included were 118 patients with malignant or probably malignant non-palpable breast lesions visible on ultrasonography in whom radio-guided lesion resection and sentinel node biopsy were indicated. 99mTechnetium-albumin colloid was injected into the periphery of the lesion under ultrasonographic guidance and all patients underwent preoperative scintigraphy.Results. From November 2001 to December 2004, 118 patients were included. All patients underwent conservative surgery, with the non- lpable lesion being located in all cases (100% lesion detection rate). The histological diagnoses were: 81 invasive ductal carcinomas (68.64%), 7 infiltrating lobular carcinomas (5.93%), 5 mixed-type carcinomas (4.24%), 17 carcinomas in situ (14.40%), and 8 other invasive carcinomas (6.78%). The sentinel node was detected in 98.41%.Discussion and conclusions. Radio-guided ROLL surgery on nonpalpable lesions located under ultrasonographic guidance is a simple, fast technique that enables the lesion to be safely excised. Both ROLL and SNOLL can be carried out in the same intervention with a single ultrasound-guided injection of 99mTechnetium-albumin colloid with satisfactory results
Subject(s)
Humans , Female , Radiopharmaceuticals , Technetium Tc 99m Aggregated Albumin , Breast Neoplasms , Breast Neoplasms , Sentinel Lymph Node Biopsy , Breast Neoplasms/pathologyABSTRACT
Lower urinary tract obstruction in women is an uncommon condition resulting from multiple either organic or functional disorders. This paper contributes one case of obstructive uropathy secondary to presence of almost complete vulvar synechia due to extreme genital atrophy, a rare entity that may appear in postmenopausal women. Partial and incomplete vulvar fusion usually occurs in significant postmenopausal atrophies, sometimes associated to urethral meatus stricture; this, however, has no significant repercussion on urination dynamics. No other comparable case was found in the reviewed literature.
