{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T21:39:31Z","timestamp":1785015571479,"version":"3.55.0"},"reference-count":18,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,10,19]],"date-time":"2022-10-19T00:00:00Z","timestamp":1666137600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Breast cancer patients having neoadjuvant systemic therapy (NAST) who have a positive (clipped) lymph node (CN) at presentation must have that CN removed to assess pathologic response at later surgery. Multiple techniques for localizing the CN have been described. We describe a novel ROLL\u2010based approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients between 2018 and 2021, having NAST with biopsy proven positive lymph node(s), had a clip placed into the most abnormal node(s). At later surgery sentinel node and occult lesion localization (SNOLL) was performed with peritumoral radio\u2010isotope (<jats:sup>99m<\/jats:sup>Tc\u2010Nanoscan) injected under ultrasound guidance. Planar and single photon emission computed tomography (SPECT\u2013CT) images were used to identify sentinel nodes (SN) and the CN. If the CN was not a SN, then additional <jats:sup>99m<\/jats:sup>Tc\u2010Nanoscan was injected directly into the CN using ultrasound (ROLL). TAD was performed using a gamma probe and intra\u2010operative specimen radiographs to confirm excision of the CN.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010eight patients underwent TAD. 20\/38 CNs were SNs on SPECT\u2010CT. 17\/38 CN were localized separately. 1\/38 CN was not a SN and could not be identified on ultrasound. The remaining 37\/38 (97.4%) of the CNs were removed intra\u2010operatively. Pathological complete response in the axilla was identified in 18\/38 cases. The CN was the only positive node in 10\/20 cases. In 18\/20 cases the CN contained the largest tumour deposit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Combining SNOLL and ROLL techniques to identify the SNs and, if separate, the CN for TAD is very reliable and logistically robust, especially for units already performing peritumoral lymphoscintigraphy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.18079","type":"journal-article","created":{"date-parts":[[2022,10,20]],"date-time":"2022-10-20T06:09:53Z","timestamp":1666246193000},"page":"3017-3021","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Radio\u2010isotope occult lesion localization (<scp>ROLL<\/scp>) techniques to identify the clipped node for targeted axillary dissection (<scp>TAD<\/scp>) in breast cancer"],"prefix":"10.1111","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9683-8913","authenticated-orcid":false,"given":"Alec A.","family":"Winder","sequence":"first","affiliation":[{"name":"Breast and Endocrine Department Mater Hospital  Wollstonecraft New South Wales Australia"},{"name":"Breast and Surgical Oncology at the Poche Centre  Wollstonecraft New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Spillane","sequence":"additional","affiliation":[{"name":"Breast and Endocrine Department Mater Hospital  Wollstonecraft New South Wales Australia"},{"name":"Breast and Surgical Oncology at the Poche Centre  Wollstonecraft New South Wales Australia"},{"name":"Breast Surgery Department North Shore Private Hospital  St Leonards New South Wales Australia"},{"name":"Breast and Melanoma Surgery Department Royal North Shore Hospital  St Leonards New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samriti","family":"Sood","sequence":"additional","affiliation":[{"name":"Breast and Endocrine Department Mater Hospital  Wollstonecraft New South Wales Australia"},{"name":"Breast and Surgical Oncology at the Poche Centre  Wollstonecraft New South Wales Australia"},{"name":"Breast and Melanoma Surgery Department Royal North Shore Hospital  St Leonards New South Wales Australia"},{"name":"General Surgery Department Hornsby Ku\u2010ring\u2010gai Hospital  Hornsby New South Wales Australia"},{"name":"General Surgery Department Northern Beaches Hospital  Frenchs Forest New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merran","family":"McKessar","sequence":"additional","affiliation":[{"name":"Department of Radiology and Department of Nuclear Medicine Mater Hospital  Wollstonecraft New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Cohn","sequence":"additional","affiliation":[{"name":"Department of Radiology and Department of Nuclear Medicine Mater Hospital  Wollstonecraft New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kylie","family":"Snook","sequence":"additional","affiliation":[{"name":"Breast and Endocrine Department Mater Hospital  Wollstonecraft New South Wales Australia"},{"name":"Breast and Surgical Oncology at the Poche Centre  Wollstonecraft New South Wales Australia"},{"name":"Breast Surgery Department North Shore Private Hospital  St Leonards New South Wales Australia"},{"name":"General Surgery Department Hornsby Ku\u2010ring\u2010gai Hospital  Hornsby New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,19]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-016-5669-2"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-019-05398-3"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.16402"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(13)70166-9"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000558"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.64.0094"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JGO.19.00351"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.15604"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000517208"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-020-09542-y"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-021-06281-w"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2013.06.006"},{"key":"e_1_2_8_14_1","first-page":"1097","article-title":"A prospective, multicenter registry study to evaluate the clinical feasibility of targeted axillary dissection (TAD) in node\u2010positive breast cancer patients","volume":"10","author":"Kuemmel S","year":"2020","journal-title":"Ann. Surg."},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.2848"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-017-6084-z"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.11470"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(14)70460-7"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13071565"}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.18079","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ans.18079","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.18079","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T19:03:49Z","timestamp":1692644629000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.18079"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,19]]},"references-count":18,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1111\/ans.18079"],"URL":"https:\/\/doi.org\/10.1111\/ans.18079","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,19]]},"assertion":[{"value":"2022-04-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}