Manipal hospital’s Comprehensive Cancer Centre and its Department of Nuclear Medicine have jointly launched an innovative technique called ROLL (Radioisotope Occult Lesion Localisation) for the benefit of patients with suspicious breast lumps and early stage breast cancers.
The Department of Nuclear Medicine has invested in a special hand-held gamma probe, which helps the surgeons in identifying and precisely removing the tumour. This ROLL technique is very simple to use and performs both-radiological and surgical. It allows the surgeon to identify the hot spot in a clear 3-Dimensional image which gives superior flexibility in planning the incision. The whole procedure is less painful as compared to the earlier techniques (i.e. wire-localisation).
According to the doctors of Manipal Comprehensive Cancer Centre, the gamma probe can be used to confirm the exact position of the hot spot before surgically removing the tumour. A specimen of the tumour is assessed with the probe to determine exact centricity of the spot and whether it is cancerous or not. According to Dr Shabber Zaveri (consultant surgical oncologist at Manipal Comprehensive Cancer Centre “The main advantage of ROLL technique is in combining sentinel lymph node procedure with the same gamma probe at one sitting if removed specimen turns out to confirm breast cancer. This gives a complete minimal invasive approach to the whole problem”.
According to an estimate almost 25% of cancerous breast tumours can not be physically felt on clinical examination. After mammography or ultra-sonography, doctors need to accurately localize the tumour for a successful surgical treatment. Till date, surgeons used mammography or ultra sonographic guided needle or wire placement around the breast to exactly locate these tumours. These techniques have some complications, often the wire gets fractured and sometimes inaccurate localisation leads to false negative biopsies. Also, needle placement is very uncomfortable with poor compliance of patients.
However, the radioisotope for this technique should be prepared with utmost precision as the shelf life of this radioisotope is only 6 hours. The dose injected is very less so that there is no risk of radiation exposure. The gamma probe picks up the emitted rays and converts them to acoustic forms, which were then displayed on a monitor.