Comparison of ultrasound localisation techniques for impalpable breast cancer

There are increasing numbers of impalpable breast cancers that require localisation prior to wide local excision. Wire localisation is the technique used in the majority of UK centres. Our centre changed to the relatively new technique of radio-isotope occult lesion localisation (ROLL) at the beginning of 2008 for ultrasound visible lesions.

All ultrasound guided localisations from January 2006 to December 2008 were reviewed. Wire localisation had been used between January 2006 and December 2007, being superseded by ROLL for a 1-year period leading up to December 2008. For all wire and ROLL localisations, lesion size on ultrasound, radiological margin on specimen radiography, histological margin, lesion size and both specimen volume and weight were recorded. Benign lesions and skin marking only were excluded.

ROLL achieved marginally superior results in terms of specimin weight although no significant differences were demonstrated in the measured indices. Our department is very happy with the technique as early experience suggests ROLL is better tolerated by patients and is surgically less restrictive with potential for a better cosmetic result.