Manipal Hospital's Comprehensive Cancer Centre and its department of Nuclear Medicine have jointly launched an innovative technique called ROLL (Radioisotope Occult Lesion Localisation) which will benefit patients with suspicious breast lumps and early stage breast cancers.
ROLL was successfully used for the first time in India at the Manipal Hospital. The department of Nuclear Medicine has invested in a special Gamma Probe to help surgeons identify and accurately remove the tumour. ROLL is easier to perform - both radiological and surgical. It allows surgeon to identify the hot spot easily in 3 dimensions giving greater flexibility in planning the incision. It is less painful compared to wire-localisation and can be performed as a day care procedure, the hospital sources informed.
Dr. Somashekhar, Consultant, Surgical Oncologist at Manipal Comprehensive Cancer Centre said, "The gamma probe, a hand held device, is used to confirm the accurate hot spot before surgically removing the tumour. A specimen of the tumour is assessed with the probe to determine exact centricity of the hot spot and whether it is cancerous. Non-randomised data from our series of many patients suggests that ROLL is superior to wire localisation."
Almost 25 per cent of cancerous breast tumours cannot be physically felt on clinical examination. After mammography or ultra-sonography, doctors need to accurately localise 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. However, the technique has 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 from the patients.
According to Dr. R.V. Parameswaran, Consultant and Head of the Department of Nuclear Medicine, the radioisotope must be prepared with utmost precision and care. The life of this isotope is just six hours and the dose injected is very small, thereby virtually reducing any effects of radiation. The gamma probe then picks up emitted rays and converts it into acoustic form as well as counts, which are displayed on the monitor.
Dr. Shabber Zaveri, Consultant Surgical Oncologist at Manipal Comprehensive Cancer Centre said, "The main advantage of ROLL 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."