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Volume 16, Number 6, 2011

Preliminary experience in sentinel node and occult lesion localization (SNOLL) technique—One center study

Beata Adamczyk, Murawa Dawid, Połom Karol, Spychała Arkadiusz, Nowaczyk Piotr, Murawa Paweł


Aim: The aim of this study was to present one center experience in applying the SNOLL
technique to patients with suspected occult breast lesions.
Background: In the last years, the widespread use of mammographic screening programs
resulted in an increasing number of women with nonpalpable suspicious breast lesions
requiring further examination. The new method called sentinel node and occult lesion
localization (SNOLL) enables the intraoperative detection of nonpalpable breast tumors and
sentinel node biopsy in one surgical procedure.
Materials and methods: 46 patients with suspected malignant lesions or diagnosed nonpalpable breast cancer were subjected to a pre-operative SNOLL procedure. The day before the surgery, theywere administered two radiotracers: one to localize the tumor and the other to localize the sentinel node. During the surgery, the breast tumor and the sentinel node,
which in most cases had been examined intraoperatively, were detected with a handheld
gamma probe and resected under its control.
Results: All 46 (100%) patients had their occult breast lesions resected. Histopathologic examination revealed cancer in 40 patients: in situ in 2 cases, invasive in 38 cases. All these
patients had their sentinel nodes examined. In one case only, the sentinel node could
not be located with a gamma probe. Intraoperative tests showed the sentinel node to be
metastatic in 5 patients, who were then given a simultaneous axillary lymphadenectomy.
In addition, the final histopathologic examination revealed metastasis to the sentinel node
in one patient, who had to be reoperated.
Conclusion: SNOLL is a modern technique that enables a precise intraoperative localization
of non-palpable suspected malignant breast lesions in combination with a sentinel node
biopsy. Extended application of intraoperative management leads to significant decrease in
the number of reoperations performed in patients with early bread cancer.

Signature: Rep Pract Oncol Radiother, 2011; 16(6) : 221-226

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