RESUMEN
The increase in the detection of occult lesions has led to the development of new localisation methods using radiopharmaceutical products. The use of these products allows us to perform a "thrifty" (less-aggressive) surgical excision and, to simultaneously carry out the biopsy of the sentinel node in cases of breast cancer. On making a search for the most up to date references on this particular topic, we found many articles on radioguided surgery by many leading international work groups. These articles clearly show the advantages of the radioguided surgery method, its effectiveness and attractiveness to surgeons who are very much involved in the search for excellence in their daily work. We also contribute our experience as a functional group, with 413 interventions on occult lesions performed using the radioguided method (ROLL). In 229 cases out of these 413, we found a malignancy (75%); in all these 229 cases it was possible to perform the intervention simultaneously with the biopsy of the sentinel node (SNOLL), during the same surgical act. However the interest created by the new procedure, it is essential to keep a critical but innovative and reflexive mind on this issue, in order to accurately analyze the results obtained by each group. We must remember that these types of methods involve several clinical specialties and, therefore, each one will have to contribute with the highest efficiency.
Asunto(s)
Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/cirugía , Radiofármacos , Femenino , Humanos , Procedimientos Quirúrgicos Mínimamente Invasivos , CintigrafíaRESUMEN
El aumento en la detección de lesiones no palpables de mama ha permitido el desarrollo de métodos de localización mediante el uso de radiofármacos que nos permiten una óptima cirugía de extirpación ahorradora y, simultáneamente, la biopsia del ganglio centinela en los casos de cáncer mamario. Revisamos la bibliografía actual acerca del tema y se aprecia una eclosión de artículos sobre cirugía radioguiada en numerosos y destacados grupos de trabajo mundiales que reflejan la bondad del método, así como su eficacia y atractivo para unos cirujanos que apuestan cada vez más por la excelencia en su labor diaria. Aportamos también nuestra experiencia como grupo funcional que se extiende a 413 intervenciones sobre lesiones no palpables realizadas de forma radioguiada (ROLL) y en 229 casos de afección maligna (75%) ha sido posible simultanear con la biopsia del ganglio centinela (SNOLL). El interés que ha despertado la técnica no debe estar exento de un espíritu crítico pero innovador y reflexivo para poder analizar de forma correcta los resultados obtenidos por cada grupo, conscientes de que estamos ante métodos en que intervienen varias especialidades y cada una deberá aportar la máxima eficiencia (AU)
The increase in the detection of occult lesions has led to the development of new localisation methods using radiopharmaceutical products. The use of these products allows us to perform a thrifty (less-aggressive) surgical excision and, to simultaneously carry out the biopsy of the sentinel node in cases of breast cancer. On making a search for the most up to date references on this particular topic, we found many articles on radioguided surgery by many leading international work groups. These articles clearly show the advantages of the radioguided surgery method, its effectiveness and attractiveness to surgeons who are very much involved in the search for excellence in their daily work. We also contribute our experience as a functional group, with 413 interventions on occult lesions performed using the radioguided method (ROLL). In 229 cases out of these 413, we found a malignancy (75%); in all these 229 cases it was possible to perform the intervention simultaneously with the biopsy of the sentinel node (SNOLL), during the same surgical act. However the interest created by the new procedure, it is essential to keep a critical but innovative and reflexive mind on this issue, in order to accurately analyze the results obtained by each group. We must remember that these types of methods involve several clinical specialties and, therefore, each one will have to contribute with the highest efficiency