Slovenská chirurgia 2/2013

Surgical treatment of non palpable breast cancer by SNOLL method

Aims: The goal of the research is to investigate efficiency of non palpable lesion excision localised by a radiotracer including sentinel lymph node biopsy. Then we evaluated sufficiency of the excision and number of reoperations resulting from inadequate oncological radicality. Material and methods: Between 2011 and 2012 we conducted 68 operations of non palpable breast cancer patients. The prospective study included 28 patients with preoperatively diagnosed breast cancer by biopsy. In case of this patients we used SNOLL method. Lesion was marked by radiotracer under ultrasound or digital sterotaxy. Sentinel node was marked using standard technique combining tracer and patent blau. Every patient was treated with concervative breast surgery. Results: Non palpable lesion was localised and excided in all patients. Sentinel node was found in 27 cases (96.5%). Reoperation was conducted in 5 cases (17.5%) for close or positive margin status and in one case for false negative perioperative sentinel biopsy. Conclusion: We found that dual technique combining albumin-macroaggregate and nanocol is reliable localisation method of non palpable lesion and sentinel node. Therefore we may conclude that SNOLL is practical and oncologically safe technique of excision of sublinical lesion in combination with sentinel biopsy.

Keywords: breast cancer, non palpable lesion, SNOLL technique, sentinel biopsy.