Radioguided Occult Lesion Localisation (ROLL) for Excision of Non-Palpable Breast Lesions, a PersonalExperience in a Patient with Multifocal Breast Cancer

Background: Breast conservation therapy (BCT) is the standard of care forearly stage breast cancer. The procedure can be a challenge for the surgeon if thelesion is non-palpable. For excision of non-palpable breast lesions, they should belocalized precisely before surgery. There are different techniques such as theWGL(Wire Guided Localization), ROLL (Radio-guided Occult Lesion Localization),etc. Some centers consider ROLL as the gold standard technique for excision ofnon-palpable breast lesions.Case presentation: A ۴۴-year-old woman with multifocal breast cancerpresented to the breast clinic. Her imaging including MRI scan confirmed thepresence of three tumors in the left breast and malignant looking nodes in the leftaxilla. Under ultrasound guidance, Core Needle Biopsy (CNB) of the breastlesions and Fine Needle Aspiration (FNA) of two lymph nodes in the left axillawere performed. Pathology of all three masses confirmed Invasive DuctalCarcinoma (IDC) andFNAof the lymph nodes was suspicious for malignancy. Shewas treated with breast conserving surgery using the ROLL technique. All threetumors were excised with adequate margins and axillary lymph node dissectionwas performed. The cosmetic results were satisfactory.Conclusion: The ROLL technique is simple to perform and has severaladvantages compared to the WGL. We recommend this procedure, especially inmultifocal non-palpable lesions.