Is SNOLL a good localization technique in early breast cancer treatment? A single center's experience

Rep Pract Oncol Radiother. 2020 Jul-Aug;25(4):594-597. doi: 10.1016/j.rpor.2020.04.022. Epub 2020 May 21.

Abstract

Aim: The aim of this study was to evaluate the method and present one center's experience in applying the SNOLL technique to patients with non-palpable suspicious breast lesions.

Materials and methods: 371 patients with suspected malignant lesions or diagnosed non-palpable breast cancer were subjected to a preoperative SNOLL procedure. The day before the surgery, they were administered two radiotracers to localize the tumor in the breast and the sentinel node. The following day, with the help of a handheld gamma probe the breast conserving surgery was performed.

Results: All 371 patients (100%) had their suspected occult breast lesions resected. Histo-pathological examination revealed cancer in 339 patients all these patients had their sentinel nodes examined. The intraoperative tests showed the sentinel node to be metastatic in 35 patients, who were then given a simultaneous axillary lymphadenectomy. Another 7 patients were diagnosed with positive lymph nodes in the final pathology and had to undergo a second operation. Reoperations compelled by positive surgical margins were performed in 26 cases.

Conclusions: SNOLL as a good technique of intraoperative localization, enables to remove a nonpalpable breast cancer together with sentinel lymph node in a single surgical procedure. It seems to be a optional method to be used in patients treated with breast conserving therapy.

Keywords: Early breast cancer; Non-palpable tumor; Radioisotopes; SNOLL; Sentinel node biopsy.