***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background The detection of sub- clinical breast lesions has increased with screening mammography . Biopsy techniques can offer precision and agility in its execution , as well as patient comfort . This trial compares radioguided occult lesion localization ( ROLL ) and wire-guided localization ( WL ) of breast lesions . We investigate if a procedure at the ambulatorial level ( ROLL ) could lead to a better aesthetic result and less postoperative pain . In addition , we intend to demonstrate the efficacy of radioguided localization and removal of occult breast lesions using radiopharmaceuticals injected directly into the lesions and correlate radiological and histopathological findings . Methods One hundred and twenty patients were r and omized into two groups ( 59 WL and 61 ROLL ) . The patients were requested to score the cosmetic appearance of their breast after surgery , and a numerical rating scale was used to measure pain on the first postoperative day . Clearance margins were considered at ≥ 10 mm for invasive cancer , ≥ 5 mm for ductal carcinoma in situ , and ≥ 1 mm for benign disease . Patients were subsequently treated according to the definitive histological result . When appropriate , different statistical tests were used in order to test the significance between the two groups , considering a P value < 0.05 as statistically significant . Results WL and ROLL  located all the occult breast lesions successfully . In the ROLL group , the specimen volume was smaller and there were more cases with clear margins ( P < 0.05 ) . There were significant differences in mean time of hospital stay  between WL and ROLL ( 21.42 vs. 2.56 hours ) , but not in operative time ( 39.4 vs. 29.9 minutes ) . There were significant differences in the subjective ease of the procedures as rated by the patients ( cosmetic outcomes and postoperative pain ) . Conclusion ROLL is an effective method for the excision of non-palpable breast lesions . It enables more careful planning of the cutaneous incision , leading to better aesthetic results , less postoperative symptoms , and smaller volumes of excised tissue Abstract Background : Wire localization ( WL ) is the current st and ard for surgical diagnosis of nonpalpable breast lesions . Many disadvantages inherent to WL are solved with radioactive seed localization ( RSL ) . This trial investigated the ability of RSL to reduce the need for specimen radiographs and operating room delays associated with WL . Methods : A total of 134 women were entered onto an institutional review board – approved study . RSL was performed by placing a titanium seed containing .29 to 20 mCi of iodine-125 to within 1 cm of the suggestive breast lesion . The surgeon used a h and held gamma detector to locate and excise the iodine-125 seed and the lesion . Results : Specimen radiographs were eliminated in 98 ( 79 % ) of 124 patients . Surgical seed retrieval was 100 % in 124 patients . No seed migration occurred after correct radiographical placement . A total of 26 ( 21 % ) of 124 patients required a specimen radiograph ; 22 ( 85 % ) of these 26 were performed for microcalcifications . Conclusions : After surgical removal , RSL can eliminate specimen radiographs when the radiologist accurately places the seed and the pathologist grossly identifies the lesion . If small microcalcifications are noted before surgery , then specimen radiographs may be necessary . RSL reduced requirements for specimen radiographs , decreased OR time , improved incision placement , and improved resections to clear margins UNLABELLED Advanced breast cancer screening techniques and their availability increased the number of non-palpable breast lesions requiring surgery . Consequently reliable and efficient therapeutic management permitting accurate localization and removal of these occult lesions is essential . AIMS In our study we evaluated radioguided occult lesion localization ( ROLL ) for effectiveness of localization , oncological safety and feasibility of concomitant sentinel node biopsy . METHODS Hundred patients ( 120 lesions ) underwent ROLL and tumour excision with or without sentinel node biopsy after confirmed histopathological findings via intra-tumoral injection of Tc99m-labelled macro-aggregate albumin for ROLL and Tc99m-labelled nanocolloids with periareolar-subdermal injection for simultaneous sentinel node biopsy . RESULTS Our detection rate for ROLL was 98.3 % , respectively , 98.6 % for sentinel nodes in cases of concomitant sentinel node biopsy . We had a radical excision rate of 55 out of 69 cases of invasive ductal cancer and 17 out of 26 cases of DCIS to achieve 1 mm , respectively , 10 mm tumour-free margins . CONCLUSIONS Intra-tumoral tracer injection of for ROLL and periareolar-subdermal tracer injection for simultaneous sentinel node biopsy seem to be a sensitive technique . According to our results ROLL is a safe , precise and simple technique permitting definitive therapeutic removal of malignant or premalignant breast lesions . The high detection rate of the sentinel node in cases with concomitant sentinel node biopsy shows that the combination of both procedures is possible and safe . In our opinion ROLL is an excellent therapeutic option after histological confirmation of malignancy or premalignant disease OBJECTIVE The aim of this investigation was to determine whether radioguided occult lesion localization and routine wire localization differ in respect to the effectiveness of complete excision of nonpalpable breast cancer lesions . SUBJECTS AND METHODS This prospect i ve r and omized study included patients with breast cancer scheduled for conservative tumor excision and sentinel node biopsy . Patients were r and omized to either radioguided localization or wire localization .  Comparative radiologic , surgical , and pathologic data were collected and analyzed to establish the duration , ease of use , and accuracy of the two techniques for occult lesion localization . The effectiveness of sentinel node biopsy also was assessed . One radiologist and two surgeons participated in the study . RESULTS Among 134 patients , 68 were treated with wire localization and 66 with radioguided localization .  The mean duration of radiologic localization was significantly shorter for radioguided localization ( p < 0.001 ) . No statistical differences were found for the other parameters studied . Radiography of the surgical specimen showed 100 % lesion excision with both techniques . Complete tumor excision with tumor-free margins was achieved in 89.4 % of patients who underwent radioguided localization group and 82.4 % of patients who underwent wire localization . Pathologic examination showed the excised tissue volume was slightly larger ( p = 0.371 ) and lesion concentricity slightly less ( p = 0.730 ) with radioguided localization . The sentinel node detection rate was 91 % with radioguided localization and 84 % with wire localization . CONCLUSION The radioguided technique is as effective as the st and ard wire technique for localization and excision of nonpalpable breast cancer lesions and is somewhat faster and simpler to perform than wire localization Background : The purpose of this study was to determine the feasibility of both lymphatic mapping and probe-guided primary tumor excision by use of intralesional tracer administration in clinical ly occult breast cancer . Methods : Sixty patients with a clinical ly occult breast lesion were prospect ively included .  Lymphoscintigraphy was performed after intratumoral injection of 99mTc-labeled nanocolloid guided by ultrasound or stereotaxis . A catheter over a localization wire was inserted for intraoperative blue dye administration by using the same imaging techniques . After sentinel node identification , the gamma-ray detection probe was used for radio-guided wide local excision in patients who underwent breast-conserving therapy .  Results : A sentinel node was visualized on the scintigrams in 56 patients 93 % and could be identified intraoperatively in 58 patients 97 % . A sentinel node contained tumor in 10 17 % of these patients . Extra-axillary sentinel nodes were visualized in 43 % , were collected in 38 % , and contained metastasis in 7 % of the patients . Complete excision of the primary tumor could be accomplished in 39 87 % of 45 patients . Conclusions : Both sentinel node biopsy and probe-guided excision of a nonpalpable breast cancer is feasible with the aid of intralesional tracer administration .  Sentinel node metastasis was found in 17 % of the patients . A remarkably high percentage of extra-axillary drainage 43 % was observed BACKGROUND It is important to optimize the localization technique for non-palpable breast lesions . METHODS One hundred consecutive women with non-palpable breast lesions were r and omized to radioguided occult lesion localization ( ROLL ) or wire localization ( WL ) . For ROLL technique (99m)Tc-labeled particles of human serum albumin were injected under breast-imaging control . Localization of the lesion was done in the operating room with the aid of a gamma-probe . All lesions were identified in an X-ray control of the surgical specimen . Categorical variables were analyzed with the Chi-square method . Significance was considered at P < 0.05 . RESULTS All procedures were performed on the same day of excision , on ambulatory basis . Both techniques result ed in 100 % retrieval of the lesions . Localization time was reduced with ROLL ( P < 0.001 ) . Clear margins were achieved in 88.9 % ROLLs and 62.5 % WLs ( P < 0.05 ) reducing the requirement of re-excision . There were significant differences in the subjective ease of the procedures in favor of ROLL technique as rated by surgeons and radiologists . CONCLUSIONS ROLL technique is as effective as WL for excision of non-palpable breast lesions , reduce localization time and probably the incidence of pathologically involved margins of excision .  ROLL appears to improve the learning curve for surgical residents and cosmesis . ROLL is an attractive alternative to WL Accurate localization of impalpable breast lesions that require biopsy is important . This r and omized trial compared radioisotope occult lesion localization ( ROLL ) with the st and ard hooked‐wire technique The aim of this study was to evaluate the feasibility of sentinel node ( SN ) biopsy in occult breast lesions with different radiopharmaceuticals and to establish the optimal lymphoscintigraphic method to detect both occult lesions and SNs ( SNOLL : sentinel node and occult lesion localisation ) . Two hundred and twenty-seven consecutive patients suspected to have clinical ly occult breast carcinoma were enrolled in the study . In addition to the radioguided occult lesion localisation ( ROLL ) procedure , using macroaggregates of technetium-99 m labelled human serum albumin ( MAA ) injected directly into the lesion , lymphoscintigraphy was performed with nanocolloids ( NC ) injected in a peritumoral ( group I ) or a subdermal site ( group II ) . In group III , a sole injection of NC was done into the lesion in order to perform both ROLL and SNOLL . Overall , axillary SNs were identified in 205 of the 227 patients ( 90.3 % ) . In 12/62 ( 19.4 % ) patients of group I and 9/79 ( 11.4 % ) patients of group III , radioactive nodes were not visualised , whereas SNs were successfully localised in 85 of 86 patients of group II ( P<0.001 ) . Pathological findings revealed breast carcinoma in 148/227 patients ( 65.2 % ) and benign lesions in 79 ( 34.8 % ) . A total of 131 axillary SNs were removed in 118 patients with breast carcinoma ; intraoperative examination of the SNs revealed metastatic involvement in 16 out of 96 cases of invasive carcinoma ( 16.7 % ) . It is concluded that the combination of the ROLL procedure with direct injection of MAA into the lesion and lymphoscintigraphy performed with subdermal injection of radiocolloids represents the method of choice for accurate localisation of both non-palpable lesions and SNs BACKGROUND Radioguided-surgery has been recently proposed in patients with clinical ly occult breast lesions . This study aim ed to evaluate the feasibility of correctly locating and eradicating , by a single intralesional injection of a radiotracer , any breast lesion and , in the case of malignancy , to perform simultaneous sentinel lymph node ( SLN ) biopsy procedure . PATIENTS AND METHODS Sixty-three women with early breast lesions were enrolled : 42 were invasive carcinomas , 16 in situ ductal carcinomas ( DCIS ) and 5 fibroadenomas . RESULTS Scintigraphic images clearly identified the lesions in all patients while SLN/s were evident in 88 % of them . At surgery all the breast lesions were easily radiolocalized and eradicated with minimum surgical trauma and , for those patients with invasive carcinomas , the SLN technique was performed in 86 % of them . No skip metastases were found . CONCLUSION A single intralesional administration of radiotracer is an easy and reliable procedure to simultaneously locate and remove both the non-palpable breast lesion and the SLN when primary malignancy was intraoperatively confirmed BACKGROUND The current study sought to vali date radioactive seed localization ( RSL ) as an alternative to wire localization ( WL ) to facilitate the operative excision of nonpalpable breast lesions . METHODS One hundred consecutive patients underwent preoperative WL  and the next 100 RSL . Margins 
    Output:
    
The results of this systematic review of RGL versus WGL demonstrate that RGL technique produces lower positive margins rates and fewer re-operations .
While this review is limited by the small size and quality of RCTs , the odds ratios suggest that RGL may be a superior technique to guide surgical resection of non-palpable breast cancers .