Simplified technique of radioguided occult lesion localization (ROLL) plus sentinel lymph node biopsy (SNOLL) in breast carcinoma
ABSTRACT Radioguided occult lesion localization (ROLL) is a new technique to detect nonpalpable breast tumors. We report our experience using injection of a single radiotracer to localize occult lesions together with sentinel lymph node (SLN) biopsy (SNOLL). The aim of this series was to evaluate the feasibility of the technique, its efficacy, and the rate of reoperation.
Under sonographic guidance, a nanocolloidal tracer was injected peritumorally above and below the lesion. A handheld gamma probe detector was used to locate and to guide its surgical removal. An intraoperative (IO) macroscopic examination of the specimen with margins evaluation and IO imprint cytology of SLN was always performed.
The targeted lesion was localized and removed in all cases. Final pathological diagnosis identified invasive in 70 patients and ductal carcinoma in situ (DCIS) in 2 patients. The average size of the resected lesion was 11 mm (4-50 mm). In 61 out of the 72 patients (85%), the breast specimen had clear and large margins. Sentinel lymph node (SLN) biopsy was performed in 70 patients with an identification rate of 90%. Final pathological SLN metastasis rate approached 25% (pN1 14%, pN1(mi) 11%). Despite intraoperative examination of the specimen, a total of 29% (21 out of 72) patients had to be reoperated (8 patients for involved margins, 10 patients for an involved SLN, and 3 for both).
This technique with a single nanocolloid tracer used both for ROLL and SLN detection is reliable for removing nonpalpable lesions. The use of this technique may have implications for further reducing reoperation rates.
- SourceAvailable from: Ann Marilyn Leitch[Show abstract] [Hide abstract]
ABSTRACT: Introduction. Breast conserving surgery (BCS) requires tumor excision with negative margins. Reexcision rates of 30-50% are reported. Ultrasound localization, intraoperative margin pathology, and specimen mammography have reduced reexcisions, but require new equipment. Cavity shave margin (CSM) is a technique, utilizing existing equipment, that potentially reduces reexcision. This study evaluates CSM reexcision impact. Methods. 522 cancers treated with BCS were reviewed. Patients underwent standard partial mastectomy (SPM) or CSM. Data collected included demographics, pathology, and treatments. Results. 455 SPMs were compared to 67 CSMs. Analysis revealed no differences in pathology, intraductal component, or neoadjuvant chemotherapy. Overall reexcision rate = 43%. Most reexcisions were performed for DCIS at margin. SPMs underwent 213 reexcisions (46.8%), versus 16/67 (23.9%) CSMs (P = 0.0003). Total mastectomy as definitive procedure was performed after more SPMs (P = 0.009). Multivariate analysis revealed CSM, % DCIS, tumor size, and race to influence reexcisions. Conclusions. CSM is a technique that reduces reexcisions and mastectomy rates.01/2012; 2012:725121. DOI:10.1155/2012/725121
Conference Paper: On creating averaging templates[Show abstract] [Hide abstract]
ABSTRACT: Dynamic Programming is normally used in creating averaging templates. However, it takes both time and memory. In this paper, we present linear averaging and dynamic local averaging as two alternative approaches. A recognition experiment was also conducted for performance comparisons. It was found that both proposed techniques not only achieve a slightly higher accuracy than dynamic averaging, but also save time and memory. The effect of length normalization on dynamic averaging and dynamic local averaging was also studied and was found not to be a significant factor.Acoustics, Speech, and Signal Processing, IEEE International Conference on ICASSP '84.; 04/1984
Conference Paper: Lossless data compression in real time[Show abstract] [Hide abstract]
ABSTRACT: This paper describes the research effort currently in progress to develop lossless data compression algorithms for seismic, speech, and image data sets. For many applications, such as transmitting and archiving research data bases, using lossy compression algorithms is not advisable. In situations where critical data (e.g. research instrumentation) is to be transmitted or archived, a real time lossless data compression algorithm is desirable. It presents a version of the algorithm using a recursive least squares a priori adaptive lattice structure followed by an arithmetic coding stage. The real time effectiveness of this algorithm is being verified by coding the technique to run on a TMS320C3x card custom developed for our applicationsSignals, Systems and Computers, 1994. 1994 Conference Record of the Twenty-Eighth Asilomar Conference on; 01/1994